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London Cardiovascular Project

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Acute aortic dissection

Intro

Aortic dissection is an emergency life threatening condition which occurs in the upper regions of the aorta in the chest cavity. At present, the emergency care for these patients is disorganised. Aortic dissection procedures are invariably undertaken by an on-call surgeon. Current referral practices often mean patients are sent to a centre with available intensive care unit bed, rather than one with the best expertise.

The on-call surgeon may, or may not, be a cardiac or vascular surgeon with experience in aortic disease, meaning that this may be the only aortic dissection case they undertake in a year.

Implementation

London Specialised Commissioning Group (LSCG) supported by the London Cardiac Networks

Project aims

Ensure there is a provider network to manage acute aortic dissection.

  • Patients should have prompt assessment and treatment by a specialist experienced surgeon.
  • Treatment should take place at a site that must have the support of other co-dependent specialities available on-site (e.g.. vascular surgery).

Implementation update

  • The service specification for this service has been agreed and the LSCG have visited all Trusts currently providing this service to assess compliance against the service specification.
  • A clinical advisory group has been identified consisting of representatives from all networks to ensure clinical engagement and support and public health representation.
  • Specialist centres have developed protocols with spoke hospitals and ambulance services (up to three ambulance services) for the rapid transfer of diagnosed or suspected AAD patients to the on-call consultant.

The work aims to ensure there is a provider network to manage acute aortic dissection.

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Documents

Cardiac Surgery Service Specification - Contains baseline data, quality standards and implementation timeframes


Project documents

Model of care (summary)
Model of care (detailed)
Patient perspective
Responses to engagement
Case for change
Co-dependencies framework
Financial analysis

More on the
patient perspective