Organ Malperfusion in Patients with Acute Aortic Dissection : Pathophysiology and Treatment

Malperfusion of aortic branch vessels is a common, but catastrophic complication of acute aortic dissection associated with poor outcomes. Branch vessel obstruction causing organ malperfusion may be static, dynamic, or a combination of both. Patients with malperfusion are more likely to have an entr...

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Bibliographic Details
Published inNihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 84; no. 10; pp. 1553 - 1564
Main Author KIMURA, Naoyuki
Format Journal Article
LanguageJapanese
Published Japan Surgical Association 2023
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Summary:Malperfusion of aortic branch vessels is a common, but catastrophic complication of acute aortic dissection associated with poor outcomes. Branch vessel obstruction causing organ malperfusion may be static, dynamic, or a combination of both. Patients with malperfusion are more likely to have an entry tear in the aortic arch and distal extension of dissection. Coronary, cerebral, and mesenteric malperfusion in particular increase the risk of death. Thus, treatment strategies that prioritize revascularization of the ischemic organ are important for such organ malperfusion. A therapeutic approach by an aortic team may facilitate early organ revascularization, leading to improved outcomes.
ISSN:1345-2843
1882-5133
DOI:10.3919/jjsa.84.1553