Dedicated expertise leads to outstanding outcomes for Type A aortic dissection at Inova Schar Heart and Vascular

Survival rates around 90%

Type A aortic dissection is a medical emergency that requires immediate surgical repair. About half the people who experience a Type A aortic dissection do not survive long enough to reach the hospital. And even when patients make it through a hospital’s doors, they face an uphill battle. Nationwide, the patient survival rate for surgical repair of a Type A aortic dissection is 50% to 60%. Yet for Inova Schar Heart and Vascular at Inova Fairfax Hospital, it’s quite a different story – approximately 90% of patients survive. What accounts for these drastically different results?

“We have centralized dissection care, an approach that we have streamlined in collaboration with our referring centers,” said Liam Ryan, MD, Medical Director of the Inova Aortic Center. “This optimized process enables us to avoid dramatically worse outcomes for most patients.”

These outstanding survival rates result from several factors including Inova cardiac surgeons’ deep experience and specialized expertise, the CVICU and CICU critical care teams, leading-edge technology in Inova’s cardiovascular OR suites, and resources that support this work across the entire clinical team.

“We have extensive experience in aortic surgery and aortic dissection repair, so we can take an aggressive approach. Our system is geared toward effectively dealing with the acuity of the problem. We are willing to treat almost any patient and give them a chance,” said cardiothoracic surgeon Ramesh Singh, MD, Surgical Director of Mechanical Circulatory Support and Shock, and Director of Robotic Cardiac Surgery, Inova Schar Heart and Vascular. “Everyone here is really dedicated to providing high-level care for people with aortic dissection.”

High cardiovascular surgical volumes and a streamlined process

Emergency aortic dissection repair is a long, complex operation that can take eight hours or more. Inova Schar Heart and Vascular offers a streamlined, systematized process that enables the team to move in an efficient, carefully orchestrated manner.

A few keys to Inova’s success include:

• Support from the health system’s administration, both within Inova Schar Heart and Vascular and across Inova as a whole
• Outstanding clinical and nursing staff who are specialized in the cardiac OR and cardiovascular critical care
• Support from the pharmacy and blood bank, who ensure the teams have access to specialty blood products and rare medications
• A surgical team that works as one, from the cardiothoracic surgeon and surgical assistant to the anesthesiologist, perfusionist, scrub nurse, circulator and techs

Another key to success is the program’s high volume. Inova’s team performs close to 400 aortic surgeries each year and cared for 72 aortic dissection patients in the 12-month period ending in October 2025, 48 of whom had suffered type A dissections.

“For complex cardiac surgeries like these, higher volume correlates with higher quality,” Dr. Ryan said. “We have an effective strategy in place because we see these very complicated patients so frequently.”

Early identification of aortic aneurysms reduce incidence of aortic dissection

Once a Type A aortic dissection happens, the next step is immediately transferring the patient to a heart center that can perform the required emergency surgical repair – and Inova Schar Heart and Vascular is the top choice of many physicians in the Washington, DC, metropolitan region and Virginia. But what can be done beforehand to reduce the incidence of aortic dissections?

One of the main reasons patients develop an aortic dissection is an aortic aneurysm. Inova Schar Heart and Vascular’s complex aortic disease program encourages providers to screen patients for aneurysms and refer patients early and often.

“Every aneurysm patient is unique,” Dr. Singh said. “When they are identified through screening and referred to us, we can monitor the aneurysm over time and advise them about when it might be appropriate to have elective surgery to prevent a rupture or dissection from ever happening.”