From the Guidelines

The diagnosis and treatment for a Stanford Type A aortic dissection is surgical intervention, as it significantly reduces mortality rates.

Surgery is the treatment of choice for Type A aortic dissection, with a mortality rate of 50% within the first 48 hours if not operated on 1
Despite high perioperative mortality (25%) and neurological complications (18%), surgery reduces 1-month mortality from 90% to 30% 1
Important predictive factors for post-operative mortality include coma, shock secondary to pericardial tamponade, malperfusion of coronary or peripheral arteries, and stroke 1
Age should not be considered an exclusion criterion for surgical treatment, as excellent surgical and quality-of-life outcomes have been reported in the elderly 1

Optimal repair of acute Type A AD involves addressing the following points:
- Aortic valve-sparing repair of the aortic root or aortic valve replacement 1
- Replacement of the aortic root if the dissection involves at least one sinus of Valsalva 1
- Re-implantation of the coronary ostia or preservation of the ostia of the coronary arteries 1
Extended therapies, such as "frozen elephant trunk" repair, may be beneficial for patients with visceral or renal malperfusion 1
Intraoperative aortoscopy and immediate post-operative imaging are crucial to confirm the effectiveness of therapy 1

From the Research

The diagnosis of Stanford Type A aortic dissection is critical for survival, and early diagnosis and treatment are essential 2
Aortic dissection is a life-threatening condition that requires close follow-up and treatment 2

The fundamental treatment of Stanford Type A acute aortic dissection is a lifesaving emergency surgery 3
Surgical methods include hemiarch replacement with a focus on entry tear, and extended surgery is performed only when resection of the entry tear is difficult 3
Endovascular stent-graft treatment is a minimally invasive and effective method to treat Stanford Type A aortic dissection 4
Aortic wrapping is a less invasive surgical approach that can be suggested as an alternative in some cases where the aortic root is not affected 5
The gold standard in cases of Stanford Type A aortic dissection consists of emergency surgical replacement of the dissected ascending aorta 5

Postoperative hypoxemia is a common complication that plays an important role in having a worse clinical prognosis 6
Effective intervention of postoperative hypoxemia is significant for the improved prognosis of patients with Stanford Type A aortic dissection 6

The overall hospital mortality for Stanford Type A acute aortic dissection is around 13.1% 3
The short-term and long-term outcomes of different sites of entry tear were examined, and no significant difference was observed among the groups 3
The presence or absence of residual entry tear did not significantly affect the outcomes 3