Surgical Management of Stanford Type A Aortic Dissection: Current Strategies and Outcomes

Abstract

Acute dissection of the ascending aorta (Stanford type A) represents one of the most critical emergencies in cardiovascular surgery and necessitates urgent operative intervention. This review aims to synthesize current surgical strategies and evaluate treatment outcomes in patients with type A aortic dissections based on recent international studies and contemporary clinical guidelines. Evidence consistently demonstrates that surgery remains the cornerstone of management, offering a substantial survival benefit compared with conservative approaches. Modern operative techniques encompass replacement of the ascending aorta, hemiarch or total arch reconstruction, aortic root procedures, and the application of hybrid approaches such as the Frozen Elephant Trunk technique. The establishment of specialized centers for aortic surgery, advances in cerebral perfusion techniques, and standardization of surgical decision-making contribute to improved early and long-term treatment outcomes.