About the South England Aortic Dissection Network

Acute aortic dissection (aAD) is the most common acute event to affect the aorta, more common even than ruptured aortic aneurysm rupture.

See: Aortic Dissection Explained (The Aortic Dissection Charitable Trust)

The population of South England is approximately 15 million people. Based on acute aortic dissection incidence data (7-10 per 100,000) we estimate that between 1,000-1,500 people each year to suffer acute aortic dissection in the region (600-900 Southeast, 400-600 Southwest).

Our regional footprint

South West Region Aortic Centres South East Region
  1. Cornwall and the Isles of Scilly
  2. Devon
  3. Somerset
  4. Bristol, North Somerset and South Gloucestershire
  5. Bath and North East Somerset, Swindon and Wiltshire
  6. Dorset
  7. Gloucestershire
Plymouth

Bristol

Oxford

Southampton

Brighton

8. Kent and Medway
9. Sussex and East Surrey
10. Frimley Health and Care
11. Surrey Heartlands
12. Buckinghamshire, Oxfordshire and Berkshire West
13. Hampshire and Isle of Wight

Governance

The network has been developed based on the seven key principles in the NHS England Acute Aortic Dissection (AD) Toolkit.

Our regional aortic centres with specialist aortic MDTs are Plymouth, Bristol, Oxford, Southampton and Brighton.

Coordinators in each aortic centre will collect the Key Performance Indicators (KPIs).

Performance will be reviewed quarterly, and an annual report published.

The two network clinical leads will review cases in which the acute pathway has not been followed. This includes late or missed diagnosis; delayed referral, delayed inter-facility patient transfer; or other concerns.

NHS England Regional acute Aortic Dissection pathway leads:

South West Region

a man in a suit and tie

Mr Marcus Brooks Consultant Vascular Surgeon North Bristol NHS Trust

South East Region

a man in a suit and tie

Mr Amit Modi Consultant Cardiac Surgery University Hospital Southampton

 

 

Regional rota and point of contact

The forty Emergency Departments in Southern England have been provided with the standard operating procedure (SOP).

The aortic team must respond to acute aortic dissection referrals in a timely manner. The receiving doctor will accept the patients for specialist care unless this is deemed inappropriate due to patient choice not to have surgery, frailty, futility (i.e. patient condition unsalvageable) or comorbidities.

When management remains with a local hospital team this must be under a named cardiology consultant or medical consultant with support available when requested from the aortic team.

Stabilisation and safe transfer

People with acute aortic dissection require critical care support both before and after surgery. Transfer to an aortic centre is ideally provided by an Adult Critical Care Transfer Service (ACCTS):

  • In the South West a 24/7 service is provided by RETRIEVE
  • In South Central the RESCUE transfer service is more limited (daytime).
  • There is currently no South East ACCTS service.

See: Safe Transfer of People with Acute Aortic Dissection (aAD)

Coordination of care through regional Multi-Disciplinary Team Meetings (MDTs)

MDTs to be quorate will have representation from cardiac surgery, vascular surgery, radiology, cardiology and/or genetic service and a dedicated coordinator.

They will meet at least monthly and all patients with acute aortic dissection will be discussed, as will people with chronic aortic dissection and concern regarding rupture.

Timely and reliable image transfer

Radiology services in the regions have been asked to implement a standard operating procedure (SOP) for the immediate transfer of CT images to their local aortic centre for any patient diagnosed with an acute aortic dissection.

Specialist treatment of all acute aortic dissections

People with Type A aortic dissection need to go immediately to surgery.

A small number of Type B patients require surgery (for rupture or malperfusion).

All acute aortic dissection patients who are surgical candidates require critical care management, and this is best provided in a specialist centre. This allows regular reassessment and access to intervention if there are signs of clinical or radiological deterioration.

Regional education programme

These web pages will be a primary source of educational resources developed by the network to learn about acute aortic dissection including information for patients and families. We have also included useful links to external resources.