Emergency repair of an acute type A dissection: 1. aortic root replacement with a mechanical valved conduit 2. replacement of the ascending aorta 3. Cabrol graft reconstruction go the left main coronary artery / ostia. There was a slightly unusual location of the primary entry tear at the left main coronary ostia, within the aortic root. Acute aortic dissection involves the ascending aorta in approximately two-thirds of patients. This is known as a Type A aortic dissection. Chest pain is the most common feature, as it was in this case, but clinical presentation can be varied. Delays in diagnosis comes at a severe cost to the patient. The complications of AD that involve the ascending aorta have been known for well over 60 years and include aortic rupture, cardiac tamponade, aortic regurgitation, and organ malperfusion. The risk of death is estimated to be 1% to 2% per hour and nonoperative treatment is associated with mortality in 60% of patients. Open surgical repair of the ascending aorta is a life-saving operation and remains the standard of care for patients with acute type A aortic dissection. This video was acquired using the Parallel Medical Clinical Camera (https://www.parallel-medical.com).
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