VICU "Rapid Response Chain": Fu Wai Hospital Successfully Treats 83-Year-Old Patient with Acute Type A Aortic Dissection

Acute Type A Aortic Dissection (Stanford A) carries an extremely high mortality rate, particularly when compounded by advanced age, multiple comorbidities, or acute myocardial infarction, making it often considered a surgical "contraindication." At Fu Wai Hospital, the nation's first Vascular Disease Intensive Care Unit (VICU) has established a "Rapid Response Chain" that continuously creates miracles for these critically ill patients.

Recently, the VICU admitted an 83-year-old patient diagnosed with Stanford Type A Aortic Dissection accompanied by a two-hour history of severe chest and back pain. The CT Angiography (CTA) revealed the dissection extended beyond the ascending aorta, compressing the Left Coronary Artery and Circumflex Branch, causing an Acute Myocardial Infarction (AMI). Compounding factors included hypertension and diabetes, resulting in an Extremely High surgical risk assessment.

Activation of the "Rapid Response Chain": Precision Multidisciplinary Collaboration Faced with this critical situation—which might be deemed a "surgical contraindication"—Professor Zhang Zhidong, Director of Surgical Medicine and Vascular Surgery at Fu Wai Hospital, led his team to an immediate decision. The patient was transferred to the operating room in under 30 minutes, a standard operation in their race against time.

In the operating room, a multi-front "Life Defense Battle" immediately commenced:

1. Anesthesia Team: Utilized precise drug strategies and advanced hemodynamic monitoring to create a stable "bridge of life" for the surgery.
2. Perfusion (ECC) Team: Rapidly established life support and precisely managed temperature and flow rates.
3. Vascular Surgery Team: Professor Zhang Zhidong successfully performed the highly complex aortic dissection repair.

VICU: The "Ultimate Gatekeeper" of Life Despite the surgical success, the most formidable challenge began in the postoperative phase for the frail, elderly patient. Upon returning to the VICU, the patient experienced severe complications, including circulatory instability and acute kidney injury.

The VICU team implemented a comprehensive, personalized treatment and care plan, involving multidisciplinary intervention including Traditional Chinese Medicine and Rehabilitation. VICU nurses and physicians ensured real-time monitoring, renal support, early mobilization, emotional counseling, and meticulous nutritional support, successfully managing the postoperative storm. Following continuous, refined treatment, the patient's vital signs stabilized, leading to transfer to the general ward and, ultimately, a full recovery and discharge.

This successful rescue underscores the superior advantage of the Fu Wai Hospital VICU system: centered around the ICU, it seamlessly integrates Emergency Medicine, Anesthesia, Perfusion, Surgery, and Postoperative Care, providing internationally leading critical care assurance for patients with extremely high-risk aortic diseases.