• Christine N H Tan and Alan G Fraser.
• Department of Anaesthesia, Critical Care and Pain Management, B3, University Hospital of Wales, Cardiff, CF 14 4XW, UK, ngukhoon@yahoo.co.uk.
• Can J Anaesth. 2014 Apr 1; 61 (4): 362378362-78.

PurposeAortic dissection is an infrequent but serious condition that often requires immediate operative intervention. We explore recent developments in the classification of aortic dissection and perioperative transesophageal echocardiography that assist with quantifying the severity of disease and facilitate its management.Principal FindingsWe describe the pivotal role of echocardiography in relation to key surgical considerations such as cannulation, aortic root surgery, perfusion in the aortic arch vessels, stenting in hybrid arch repair, and timing of preventative surgery.ConclusionDevelopments in the classification of aortic dissection have improved our perspective and understanding of the key presenting features that affect mortality. Improvements in patient outcome may be achieved in part by appropriately timed echocardiography-guided surgery.

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