What is the first-line treatment for aortic dissection type A?

In the case of aortic dissection type A, which involves the ascending aorta and can lead to serious complications, the first-line treatment is surgical intervention. This is primarily because dissections involving the ascending aorta carry a high risk of mortality and require immediate correction to prevent further complications such as aortic rupture, organ ischemia, or cardiac tamponade.

Surgical repair of the aorta is essential in these cases to stabilize the structure of the aorta and restore normal blood flow. The surgical approach often involves resection of the affected segment of the aorta and replacement with a graft, or possible repair of the aorta depending on the extent of the dissection and patient factors.

While medical management, including blood pressure control often with beta-blockers, plays a crucial role in managing these patients perioperatively or for those with type B dissections (not involving the ascending aorta), it is not sufficient alone for type A dissections. Angioplasty is generally not utilized for type A dissections as it does not address the primary issue of structural instability in the ascending aorta.

This surgical priority reflects the urgency of treatment required for type A dissections, making surgical management the definitive approach. Therefore, selecting surgery as the primary treatment aligns