Acute aortic dissection is a pathological catastrophe that is frequently fatal. Lifesaving emergency surgery is indicated in almost all cases, and it remains one of the highest-risk procedures.

The best results are achieved in centers that provide a specialized aortic service. Cedars-Sinai has developed such a service—the Cedars-Sinai Specialist Aortic Service (CSSAS). It goes beyond the expertise of the individual cardiac surgeons who provide the dedicated on-call rotation for aortic dissection. CSSAS comprises highly specialized anesthesiologists, perfusionists, intensivists, cardiologists and vascular surgeons.

Looking beyond emergency surgery

The Smidt Heart Institute service has the capacity to look beyond the immediate situation. Improved early and long-term outcomes for type A aortic dissection are proven with continued selective cerebral perfusion, aortic valve-sparing root replacement, and extension of the aortic repair distally into the arch with a frozen elephant trunk or other endovascular stent.

Prevention as a first defense against aortic dissection

Even better than waiting to diagnose an aortic dissection is preventing it. Patients who might be at risk of developing aortic dissection are assessed by a multidisciplinary team of cardiac and vascular surgeons, cardiologists and radiologists who use advanced imaging techniques in cross-sectional imaging—including volumetric analysis and compliance measurement—to predict an individual patient’s risk and advise the patient on the best time to undergo prophylactic surgery.

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