[Emergency Surgical Treatment of Stanford Type A Acute Aortic Dissection]

Our emergency surgical strategy for patients with Stanford type A acute aortic dissection is as follows. 1) Emergency surgery is conducted for patients with communicating aortic dissection. In addition, Emergency surgery is mandatory for patients within 24 hours after the onset of non-communicating aortic dissection. 2) Ascending aorta replacement (including hemi-arch replacement) is performed in case of the intimal tear site is in the ascending aorta or in the descending aorta and the site is not identified. Total arch replacement is performed in case of the site is in the aortic arch. 3) Early organ reperfusion is preceded to the central repair operation for patients with complicated malperfusion. 4) After dissecting sufficiently the adventitial site of aortic root, transect the aortic dissection wall at 5 mm above the sinotubular junction so as not to leave false lumen cavity as much as possible. Our efforts adding revision to the surgical strategy and technique have improved the outcome of the treatment for Stanford type A acute aortic dissection.