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Review
. 2019 Nov;34(6):610-615.
doi: 10.1097/HCO.0000000000000667.

Type A aortic dissection complicated by malperfusion syndrome

Elizabeth L Norton  1 , Minhaj S Khaja  2 , David M Williams  2 , Bo Yang  3
Affiliations
Review

Type A aortic dissection complicated by malperfusion syndrome

Elizabeth L Norton et al. Curr Opin Cardiol. 2019 Nov.

Abstract

Purpose of review: Malperfusion is present in up to 40% of acute type A aortic dissections (ATAADs) and results in increased morbidity and mortality. This review presents different management strategies in patients with ATAAD and malperfusion to improve outcomes.

Recent findings: While the ideal management strategy of ATAAD complicated by malperfusion has yet to be determined, the literature provides evidence for additional techniques to be used in conjunction with central aortic repair to reduce mortality.

Summary: Recent findings support a role for initial reperfusion and delayed central aortic repair, although optimal management strategy remains debated.

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Figures

Figure 1:
Figure 1:
A 32-year-old Marfan syndrome patient with acute type A aortic dissection (black arrowhead) (A) and pain and weakness of bilateral lower extremities with occluded left femoral artery (white arrow) (B). Aortic flap fenestration (black arrow) (C) and stenting (white arrow) (D) were performed above the celiac artery. The patient continued to have true lumen narrowing of the abdominal aorta and lower extremities with a residual 20mm gradient in the legs. A second infra-renal aortic fenestration/stenting (white arrowhead) was performed (E) and additional bare metal stents were placed in the true lumen of both iliac arteries (F) with resolution of the gradient.
See this image and copyright information in PMC

References

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