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Aspect
Open surgical repair:
• Indications
• Specifics of the dissection process relative to chronicity
• Surgical approach
▶ management of major aortic branch vessels
▶ types and diameters
▶ organ protection techniques
▶ perioperative hemodynamic management protocols
• Zonal anatomic extent of repair
Spinal cord ischemia (SCI):
• Any maneuvers used to mitigate SCI
• Placement of cerebrospinal fluid (CSF) drains
• Use of:
▶ intraoperative neurophysiologic
▶ monitoring, including electroencephalography
▶ somatosensory and motor evoked potentials
▶ cerebral oximetry
• Changes in neurophysiologic monitoring and management
• Specific blood pressure protocols for intraoperative and postoperative spinal cord
protection
Synchronous vs metachronous disease:
• Lesions that are not related to the initial aortic dissection and are separated by any
length of normal aorta should be considered metachronous.
• Any new dissection that is continuous with the initial dissection is considered
synchronous and should be listed as progression of disease or a failure of the initial
management strateg y.
