What is the clinical evidence from this study?

Study design: Cohort. Population: Acute type A aortic dissection complicated by mesenteric malperfusion (n=246). Intervention: Femoral arterial perfusion guided by intraoperative transesophageal echocardiography. Primary outcome: Survival to discharge.

What question did this study set out to answer?

The aim is to assess how effective femoral arterial perfusion is in patients with acute type A aortic dissection who also have mesenteric malperfusion.

April 13, 2026Open Access

Femoral Arterial Perfusion Guided by Intraoperative Transesophageal Echocardiography for Mesenteric Malperfusion in Acute Type A Aortic Dissection

Key Result

Femoral arterial perfusion guided by intraoperative transesophageal echocardiography achieved an 87.5% survival to discharge rate in patients with acute type A aortic dissection and mesenteric malperfusion.

Key Points

The aim is to assess how effective femoral arterial perfusion is in patients with acute type A aortic dissection who also have mesenteric malperfusion.
Critical assessment of patients with acute type A aortic dissection
Management of mesenteric malperfusion with femoral arterial perfusion
Utilization of intraoperative transesophageal echocardiography for guidance
Improved outcomes in patients undergoing femoral arterial perfusion
Enhanced visualization of cardiac structures during the procedure with TEE
Demonstration of effective management strategies for mesenteric malperfusion

Study Design

Type

Cohort (n=246)

Multicenter

Structured PICO

Does femoral arterial perfusion guided by intraoperative TEE improve outcomes in patients with acute type A aortic dissection complicated by mesenteric malperfusion?

Population

Patients with acute type A aortic dissection (ATAAD) complicated by mesenteric malperfusion

Intervention

Femoral arterial perfusion guided by intraoperative transesophageal echocardiography (TEE)

Outcome

Outcomes

This study evaluates the outcomes of using femoral arterial perfusion guided by intraoperative TEE for managing mesenteric malperfusion in acute type A aortic dissection.

Limitations

Single-center retrospective analysis with a relatively small sample size
Assessment of mesenteric reperfusion relied primarily on intraoperative TEE, which may not reliably detect persistent celiac artery or superior mesenteric artery obstruction
Depends on the anesthesiologist's expertise in TEE
Direct comparison with alternative management strategies was not possible due to institutional practices
Unmeasured clinical variables, including variations in hemodynamic status, may have influenced the outcomes

Abstract

Objectives: This study evaluated the outcomes of acute type A aortic dissection (ATAAD) complicated by mesenteric malperfusion managed with femoral arterial perfusion and intraoperative transesophageal echocardiography (TEE).

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Cite This Study

Ito et al. (Thu,) conducted a cohort in Acute type A aortic dissection complicated by mesenteric malperfusion (n=246). Femoral arterial perfusion guided by intraoperative transesophageal echocardiography was evaluated on Survival to discharge. Femoral arterial perfusion guided by intraoperative transesophageal echocardiography achieved an 87.5% survival to discharge rate in patients with acute type A aortic dissection and mesenteric malperfusion.

synapsesocial.com/papers/69dc87ea3afacbeac03e9f82 https://doi.org/https://doi.org/10.3400/avd.oa.26-00006