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Dr. William Brinkman“Code Aorta” for Acute Aortic Dissections: Time is of the Essence

Aortic dissections have been described as ticking time bombs—the sooner patients with this condition are treated, the better the outcome.

As a high volume center, the surgeons and cardiologists on the medical staff at The Heart Hospital Baylor Plano performed 57 dissections in 2016.* When it comes to aortic dissections, timelin​ess and experience is what counts.

A multidisciplinary team of cardiothoracic surgeons, vascular surgeons, cardiologists on the medical staff, as well as nursing staff, at The Heart Hospital Baylor Plano has recently evaluated our hospital’s process of treating patients with aortic dissection. This team ultimately developed a “Code Aorta” protocol to assess patients referred to The Heart Hospital with possible aortic dissection and, if necessary, rush them into emergent surgery as quickly as possible. A key focus of the Code Aorta protocol focuses on patient transfers to The Heart Hospital from other hospitals that are not equipped to treat patients with aortic dissections. Patient transfers are now coordinated through the Patient Transfer Center using a standardized set of high-yield clinical questions related to imaging, physiology, and laboratory values. This process allows clinicians at The Heart Hospital to begin preparing for patients and minimize redundant testing prior to treatment. The number to call for the Patient Transfer Center is 214.820.6444.

Code Aorta allows access to prompt transfers to our team that has extensive experience in treating patients with aortic dissections.

What happens when you call

The Patient Transfer Center will put you directly through to the on-call surgeon. After you brief the surgeon, the referral center will accept your patient for surgical intervention.

What happens next

The Patient Transfer Center will notify our thoracic aortic emergent team, launching our quick, efficient patient care pathway, with protocols based on best practices from nationally recognized cardiac programs.

Why the call is critical

An acute aortic dissection emergency has a mortality rate of 1% each hour that treatment is delayed.** Left untreated, this emergency has a mortality rate of 21% at day one, 74% at day 14 and 93% at one year. With acute aortic emergencies, speed is essential.

Code Aorta was implemented at The Heart Hospital in January 2016. Given that patient survival is strongly correlated with rapid treatment of aortic dissections, the Code Aorta protocol is likely to improve patient outcomes. Clinicians at The Heart Hospital have documented the Code Aorta protocol with the intent of sharing this process with other doctors and hospitals at national meetings in order to spread the positive impact of Code Aorta reaches to as many patients as possible.

*Arsalan M, Squiers JJ, Herbert MA, MacHannaford JC, Chamogeorgakis T, Prince SL, Hamman BL, Knoff C, Moore DO, Harrington KB, DiMaio JM, Mack MJ, Brinkman WT, Comparison of Outcomes of Operative Therapy for Acute Type A Aortic Dissections Provided at High-Volume Versus Low-Volume Medical Centers in North Texas, The American Journal of Cardiology, Volume 119, Issue 2, 2017, Pages 323-327
** Hirst AE Jr, Johns VJ Jr, Kime​ SW Jr, Dissecting aneurysm of the aorta: A review of 505 cases. Medicine (Baltimore) 1958; 37:217-79​