State-of-the-Art Surgical Management of Acute Type A Aortic Dissection

Can J Cardiol. 2016 Jan;32(1):100-9. doi: 10.1016/j.cjca.2015.07.736. Epub 2015 Aug 21.


Acute type A aortic dissections still present a major challenge to cardiac surgeons. Although surgical management remains the gold standard, operative mortality remains high, including in experienced centres. Nevertheless, recent advances in the understanding and management of various aspects of these complex operations are expected to improve overall patient outcomes. The Canadian Thoracic Aortic Collaborative (CTAC) represents a group of surgeons with interest and expertise in the management of patients with aortic diseases. The purpose of this state-of-the-art review is to detail our approach to the contemporary surgical management of acute type A aortic dissections. We focus specifically on cannulation strategies, cerebral protection, and extent of proximal and distal resection. In addition, specific clinical scenarios-including malperfusion, intramural hematomas, and surgery in octogenarians-are explored.

Publication types

  • Review

MeSH terms

  • Aortic Aneurysm, Thoracic / surgery*
  • Aortic Dissection / surgery*
  • Humans
  • Vascular Surgical Procedures / methods*
  • Vascular Surgical Procedures / standards*