Mesenteric malperfusion Syndromes in type A Aortic Dissection: Current management strategies

Author(s):  
Pierre M. Sfeir ◽  
Khalil Issa ◽  
Chakib M. Ayoub
Aorta ◽  
2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Gregory Trachiotis ◽  
Conor Hynes ◽  
Shawn Sarin ◽  
Michael Greenberg

2021 ◽  
pp. 153857442110171
Author(s):  
Mona Jaffar-Karballai ◽  
Tien Thuy Tran ◽  
Oyinkan Oremakinde ◽  
Somama Zafar ◽  
Amer Harky

Over the decades, it has been well established that malperfusion complicates a number of acute type A aortic dissection (ATAAD) patients. Of the many complications that arise from ATAAD is malperfusion, which is the result of true lumen compression secondary to the dissection, and it is one of the most dangerous complications. Left untreated, malperfusion can eventually compromise circulation to the vascular beds of almost all vital organs. Clinicians must consider the diagnosis of malperfusion promptly following a diagnosis of acute aortic dissection. The outcomes post-surgery for patients with ATAAD with concomitant malperfusion remains poor, despite mortality for aortic surgery improving over time. Optimal management for ATAAD with associated malperfusion has yet to be implemented, further research is warranted to improve the detection and management of this potentially fatal pathology. In this review, we explore the literature surrounding the complications of malperfusion in ATAAD and the various symptom presentations, investigations, and management strategies available.


2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Sidharth Viswanathan ◽  
Vivek Agrawal ◽  
Shashidhar Kallappa Parameshwarappa ◽  
Ajay Savlania ◽  
Santhosh Kumar ◽  
...  

Progressive dilatation of the false lumen in the arch and descending aorta has been encountered in one-third of survivors as a late sequelae following repair of ascending aortic dissection. Conventional treatment for the same requiring cardiopulmonary bypass and deep hypothermic circulatory arrest is associated with high morbidity and mortality especially in the elderly cohort of patients. Herein we report a case of symptomatic progressive aneurysmal dilatation of residual arch and descending thoracic aortic dissection following repair of type A aortic dissection, successfully treated by total arch debranching and ascending aortic prosthesis to bicarotid and left subclavian bypass followed by staged retrograde aortic stent-graft deployment. This case report with relevant review of the literature highlights this clinical entity and the present evidence on its appropriate management strategies. Close surveillance is mandatory following surgical repair of type A aortic dissection and hybrid endovascular procedures seem to be the most dependable modality for salvage of patients detected to have progression of residual arch dissection.


2020 ◽  
Author(s):  
Imran Khan ◽  
Prashant Joshi ◽  
Adrian W. Pick ◽  
Julian A. Smith

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