Aortic coarctation type A is usually diagnosed and surgical treatment (ascending aortic replacement, Sun procedure, etc.) or endoluminal intervention should be considered immediately. In clinical practice, aortic coarctation with an intimal breach in the ascending aorta is defined as type A by the Stanford classification. Surgical approach (entrapment involving the arch): full arch replacement + stenting of the elephant trunk is recommended for age <70 years, and partial arch replacement is possible for age >70 years, provided that the primary dissection is eliminated. Relative contraindications to surgery are coma, continuous cardiopulmonary resuscitation, gastrointestinal ischemia with bloody or black stools. Aortic coarctation is a fatal cardiovascular disease with a high mortality rate, especially type A aortic coarctation, and must be treated with urgent surgical intervention. Specific treatment should follow clinician instructions to avoid adverse events.