Objectives. Acute type-A aortic dissection (ATAAD) is still one of the most challenging diseases that cardiac surgeons encounter. Design.
This review is based on the current literature and includes the results
from the Nordic Consortium for Acute Type-A Aortic Dissection (NORCAAD)
database. It covers different aspects of ATAAD and concentrates on the
outcome of surgical repair. Results and conclusions. The
diagnosis is occasionally delayed, and ATAAD is usually lethal if prompt
repair is not performed. The dynamic nature of the disease, the
variation in presentation and clinical course, and the urgency of
treatment require significant attentiveness. Many surgical techniques
and perfusion strategies of varying complexity have been described,
ranging from simple interposition graft to total arch replacement with
frozen elephant trunk and valve-sparing root reconstruction. Although
more complex techniques may provide long-term benefit in selected
patients, they require significant surgical expertise and experience.
Short-term survival is first priority so an expedited operation that
fits in with the surgeon’s level of expertise is in most cases
appropriate.