Malperfusion in Acute Type A Aortic Dissection: Management Strategies.
Mona Jaffar-KarballaiTien Thuy TranOyinkan OremakindeSomama ZafarAmer HarkyPublished in: Vascular and endovascular surgery (2021)
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.
Keyphrases
- aortic dissection
- minimally invasive
- risk factors
- systematic review
- newly diagnosed
- ejection fraction
- coronary artery bypass
- palliative care
- prognostic factors
- adipose tissue
- type diabetes
- pulmonary hypertension
- coronary artery
- chronic kidney disease
- left ventricular
- insulin resistance
- sensitive detection
- atrial fibrillation