Malperfusion in acute type A aortic dissection: how we handle the challenge?

Paneer Selvam Krishna Moorthy; Abdul Samad Sakijan

doi:10.1007/s12055-021-01292-0

Malperfusion in acute type A aortic dissection: how we handle the challenge?

Indian J Thorac Cardiovasc Surg. 2022 Apr;38(Suppl 1):122-131. doi: 10.1007/s12055-021-01292-0. Epub 2022 Jan 28.

Authors

Paneer Selvam Krishna Moorthy¹, Abdul Samad Sakijan²

Affiliations

¹ Department of Cardiothoracic Surgery, National Heart Institute, 145 Jalan Tun Razak, 50400 Kuala Lumpur, Malaysia.
² Department of Imaging & Non-Invasive Laboratory, National Heart Institute, 145 Jalan Tun Razak, 50400 Kuala Lumpur, Malaysia.

Abstract

Malperfusion syndrome (MPS) complicating acute type A aortic dissection (ATAAD) poses a continuing challenge and management dilemma for cardiovascular surgeons. MPS may involve any of the major arterial side branches resulting in myocardial, cerebral, spinal cord, visceral, and/or limb ischemia with varying frequency and severity. Despite the continuous improvement in diagnosis and management strategies for MPS with ATAAD, clinical outcomes remain poor and the optimal therapy is still debatable. The present review aimed to assess current evidence on ATAAD patients with MPS and how best to handle the challenge.

Keywords: Aortic dissection; Endovascular repair; Malperfusion syndrome; Open surgery.

Publication types

Review