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Review
. 2018 Mar 31:4:65.
doi: 10.21037/jovs.2018.03.13. eCollection 2018.

Malperfusion syndromes in type A aortic dissection: what we have learned from IRAD

Paolo Berretta  1 , Santi Trimarchi  2 , Himanshu J Patel  3 , Thomas G Gleason  4 , Kim A Eagle  5 , Marco Di Eusanio  1
Affiliations
Review

Malperfusion syndromes in type A aortic dissection: what we have learned from IRAD

Paolo Berretta et al. J Vis Surg. .

Abstract

Patients presenting with type A acute aortic dissection (TAAD) complicated by malperfusion syndromes represent one of the highest surgical risk cohorts for cardiovascular surgeons. In the setting of aortic dissection, end-organ ischemia may involve any of the major arterial side branches resulting in myocardial, cerebral, spinal cord, visceral and/or limb ischemia. In TAAD patients with malperfusion, notwithstanding continuous improvement in diagnostic and management strategies, surgical and clinical outcomes remain poor and the optimal therapy is controversial. The present review aimed to assess current evidence on TAAD patients with the complication of malperfusion, as enunciated by the International Registry of Acute Aortic Dissection (IRAD) investigators.

Keywords: Aortic dissection; International Registry of Acute Aortic Dissection (IRAD); aortic surgery; malperfusion syndrome.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Left coronary artery malperfusion (red arrow) in type A acute aortic dissection.
Figure 2
Figure 2
TAAD complicated by cerebral malperfusion due to right carotid artery occlusion (red arrow). TAAD, type A acute aortic dissection.
Figure 3
Figure 3
TAAD with totally collapsed true lumen in abdominal aorta and visceral malperfusion (red arrow). TAAD, type A acute aortic dissection.
See this image and copyright information in PMC

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