**Abstract**

Type A Aortic dissection is a life-threatening emergency. It has varied clinical presentation from acute severe chest pain radiating to the back, collapse due to aortic rupture or pericardial tamponade or features of myocardial infarction, end organ or limb ischemia. The outcome is determined by the extent of the dissection, timing of presentation, comorbid factors, prompt diagnosis, adequate cerebral protection strategies, and skilled post-operative intensive care. Good immediate and mid-term results have been obtained with standard surgical techniques of aortic root, ascending aorta +/− hemi arch replacement. Endovascular techniques can be used as a hybrid procedure to provide more durable long term results.

**Keywords:** dissection, cerebral protection strategies, aortic root, ascending aorta, hemi arch, endovascular techniques
