Acute aortic dissection represents the most common aortic condition requiring urgent surgical therapy. This condition is generally classified as either:

• Type A, which refers to dissection involving the ascending thoracic aorta
• Type B, which involves the descending aorta.

Type A Dissection

Type A dissection
Click to enlarge.Type A dissection represents a surgical emergency, with a mortality rate as high as 1 percent per hour without surgical treatment. Duke Life Flight allows emergency air transport of these critically ill patients to Duke University Medical Center, where they are taken directly to the operating room for surgical intervention with Duke cardiac surgeons.

Type B Dissection

Endovascular stent
Click to enlarge.Type B dissection patients also frequently require surgical intervention for so called "complicated" dissection. This generally refers to type B dissection associated with impending or frank rupture or malperfusion of critical vascular beds.

These patients may also gain immediate access to the Duke University Health System via Life Flight. These complicated lesions are increasingly being treated with endovascular stent techniques, with results superior to open surgery.