Slisatkorn W.Wongkornrat W.Chartrungsan A.Sanphasitvong V.Luangthong N.Mahidol University2026-01-012026-01-012025-01-01Asian Cardiovascular and Thoracic Annals (2025)02184923https://repository.li.mahidol.ac.th/handle/123456789/113706Acute type A aortic dissection is a life-threatening condition that requires urgent surgical intervention. This article presents our institutional approach, offering a systematic, step-by-step guide to surgical management. Key aspects include preoperative preparation, intraoperative monitoring, arterial cannulation strategies, management of malperfusion, cardiopulmonary bypass, myocardial and cerebral protection, and reconstruction of the aortic root, arch, coronary artery, and left subclavian artery. The use of the frozen elephant trunk technique with hybrid devices is described in detail. Operative photographs, echocardiography, and computed tomography angiography are incorporated to support technical understanding and clinical practice.MedicineArticleSCOPUS10.1177/021849232514078242-s2.0-10502542871318165370