Acute Type A Aortic Dissection

Author: Dawn S. Hui, MD
Institution: UT Health San Antonio
Date Reviewed: May 2025
Learning Domain: Adult Cardiac Surgery
Learning Objective: Evaluation of and surgical management of Acute Type A Aortic Dissection
PowerPoint File: Acute Type A Aortic Dissection

Discussion Points

• Cannulation options – central versus peripheral, axillary versus femoral
• Impact of malperfusion on cannulation strategy
• Management of intra-operative rupture
• Management of root/valve - criteria for root replacement, VSRR versus Bentall
• Cerebral protection
• Myocardial protection
• Long-term follow-up strategy

Learning Points

• Initial management is intensive anti-impulse treatment
• Surgical goals are 
  • Complete resection of all tears
  • Obliteration of false lumen
  • Meticulous technique to prevent late complications
• Root/Valve management is dictated by extent of destruction and root dimension
• Cerebral and Myocardial Protection are paramount for a meaningful outcome
• Long-term medical follow-up and periodic imaging surveillance are necessary