The changing surgical approach to acute type A aortic dissection

Acute type A aortic dissection (ATAAD) is a surgical emergency that requires immediate intervention once recognised, mortality rate from such condition can be as high as 75% if not managed on time. Currently, the gold standard method for management of such life-threatening condition is open repair. The extent of the aorta to be repaired is dependent on many factors, primarily the extend of the dissected aorta and patients haemodynamic status at the time of presentation. Nevertheless, the surgeon experience and availability of hybrid approach to treat it, have direct influence on the approach to treat ATAAD. With advancement in operative techniques and graft modalities, there is marked shift in managing such lethal condition from total open repair to open repair of the aortic root with frozen elephant trunk (FET) and lately the role of endovascular management of ATAAD. In this review article, we will focus on the current advancement and changing trend in surgical management of ATAAD.