This study examines surgical outcomes in patients with Type A acute aortic dissection (AAAD) complicated by coronary malperfusion, focusing on transportation type and clinical management. Analyzing 70 cases, researchers found no significant mortality differences between direct transfers and referrals. However, preoperative extracorporeal membrane oxygenation (ECMO) was not a definitive solution. Diagnostic-only coronary angiography (CAG) without successful reperfusion posed a higher fatality risk, especially with left coronary artery involvement.