August 8, 2019Open Access
View Full PaperType A aortic dissection complicated by malperfusion syndrome
Structured PICO
What are the optimal management strategies, such as initial reperfusion and delayed central aortic repair, to reduce mortality in patients with acute type A aortic dissection complicated by malperfusion?
P
Population
Patients with acute type A aortic dissections (ATAADs) complicated by malperfusion syndrome
I
Intervention
Initial reperfusion and delayed central aortic repair, or additional techniques in conjunction with central aortic repair
O
Outcome
Mortality and morbidityhard clinical
Initial reperfusion followed by delayed central aortic repair may reduce mortality in patients with acute type A aortic dissection complicated by malperfusion, though optimal management remains debated.
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.