Multidisciplinary Collaboration in the Performance of Aortic Surgery
Updated: October 22, 2026
- Intraoperative care of patients undergoing complex aortic interventions depends on the continuous and coordinated work of multiple professionals, including but not limited to surgeons, anesthesiologists, and perfusionists, working together as part of a multidisciplinary aortic team (MAT). These surgeries often require disruption of normal circulatory pathways, necessitating seamless coordination and communication within the MAT to protect at-risk organs and successfully complete the aortic repair.
- Acute Type A aortic dissection (ATAAD) is a life-threatening cardiovascular emergency with pre-hospital mortality up to 40%, and perioperative mortality of 10% to 25%. Early surgical intervention is required to prevent or treat its complications, which include cardiac tamponade, severe aortic regurgitation with heart failure and shock, coronary dissection with myocardial ischemia, end-organ malperfusion, and vessel rupture.
- A major source of morbidity in open TAAA repair is the cross-clamping of the thoracoabdominal aorta, which induces proximal hypertension and distal ischemia. Perfusion strategies include no perfusion (clamp and sew), passive shunts, left heart bypass, CPB, and extra-corporeal membrane oxygenation. Perfusion strategies vary significantly and depend on the extent of the repair, conduct of the operation, as well as institutional and surgeon preference.