Management of brain malperfusion in acute type A aortic dissection

Abstract

This review discusses the management of acute Type A aortic dissection (ATAAD) complicated by cerebral malperfusion (CMP). While prompt surgical repair is the accepted standard of care for ATAAD, there remains uncertainty and debate about the optimal management of the subgroup of ATAAD patients with CMP. Examined topics include overall survival and neurologic outcomes after surgical repair of ATAAD with CMP, how the severity of presenting neurologic deficits impacts the decision and timing of operation, predictors of postoperative neurologic recovery, and a suggested management algorithm for ATAAD with CMP based upon the best available clinical evidence.

Keywords: Malperfusion; anatomy; aortic; aortic dissection; brain; cardiac; cerebral complications; disease; function; injury; outcomes (incl mortality morbidity survival etc.); stroke.