Where next for type B aortic dissection?

Abstract

In April 2021 the acute aortic dissection toolkit was launched by NHS England.1 It was designed to improve the care of patients with acute aortic dissection (AD) by raising awareness of the condition and introduced seven key principles of management including better governance, 24/7 rotas and specialist care. Each NHS region in England was encouraged to form an AD group, benchmark their current service against the toolkit principles and then try to improve their management of these patients by addressing deficiencies. The toolkit provided tools for self-assessment together with protocols to improve deficiencies by sharing best practice. A regular series of regional meetings has been held with clinicians and managers to advise and help progress – engagement with the process and feedback has been good. National key performance indicators are being developed to monitor the overall effect of the toolkit. Although the toolkit applies to all dissections, there is inevitably a bias towards management of type A dissections because many need urgent cardiac surgical repair. So where next and what about type B dissections?