The objective of the present study was to model the effects of a reduced number of treatment centers for acute type A aortic dissection on preclinical transportation distance and time. We examined whether treatment in selected centers in Germany would be implementable with respect to time to treatment. For our transportation model, the number of aortic dissections and respective mean annual volume were collected from the annual quality reports (2015-2017) of all German cardiac surgery centers (n = 76). For each German postal code, the fastest and shortest routes to the nearest center were calculated using Google Maps. Furthermore, we analysed data from the German Federal Statistical Office from Jan. 2005 to Dec. 2015 to identify all surgically treated patients with acute type A aortic dissection (n = 14102) and examined the relationship between in-hospital mortality and mean annual volume of medical centers. Our simulation showed a median transportation distance of 27.13 km and transportation time of 35.78 min for 76 centers. Doubling the transportation time (70 min) would allow providing appropriate care with only 12 medical centers. Therefore, a mean annual volume of > 25 should be obtained. High mean annual volume was associated with significantly lower in-hospital mortality rates (p < 0.001). A significantly lower mortality rate of 14% was observed (p < 0.001) if a mean annual volume of 30 was achieved. Operationalising the volume-outcome relationship with fewer but larger medical centers results in lower mortality, which outweighs the disadvantage of longer transportation time.