Wound healing — MCQs

A 45-year-old woman presents to the emergency department with sudden-onset tearing chest pain radiating to her back. She has a history of hypertension and is a current smoker. Blood pressure is 178/96 mmHg in the right arm and 142/80 mmHg in the left arm. Heart rate is 96 bpm. She is diaphoretic but alert and oriented. Chest radiograph shows a widened mediastinum. CT chest with IV contrast demonstrates a Stanford Type A aortic dissection with an intimal flap involving the ascending aorta. After initiating IV beta-blockade for immediate heart rate and blood pressure control, which of the following is the most appropriate next step in definitive management?