Management of the Aortic Arch in Acute Aortic Dissection Type A

Kunihara, Takashi; Schäfers, Hans‐Joachim

doi:10.1007/978-3-030-66668-2_22

Cited by 1 publication

(1 citation statement)

References 76 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the case reports, the patient's intestinal necrosis was removed and the common iliac artery was bypassed to the superior mesenteric artery. Subsequently, after confirming the improvement of acidosis, ascending aortic replacement was performed on the same day, successfully saving the patient's life [56][57][58][59][60]. These findings suggest that in cases where patients with ATAAD have malperfusion of the superior mesenteric artery, considering a bypass graft before central aortic repair can also be an effective treatment option.…”

Section: Superior Mesenteric Artery Revascularization Was Given Prior...mentioning

confidence: 99%

Surgical choice for the treatment of partial intestinal ischemic necrosis caused by acute type a aortic dissection combined with malperfusion of superior mesenteric artery

Yu,

Liang,

Gao

et al. 2024

J Cardiothorac Surg

View full text Add to dashboard Cite

Acute type A aortic dissection is a severe cardiovascular disease characterized by rapid onset and high mortality. Traditionally, urgent open aortic repair is performed after admission to prevent aortic rupture and death. However, when combined with malperfusion syndrome, the low perfusion of the superior mesenteric artery can further lead to intestinal necrosis, significantly impacting the surgery’s prognosis and potentially resulting in adverse consequences, bringing. This presents great significant challenges in treatment. Based on recent domestic and international research literature, this paper reviews the mechanism, current treatment approaches, and selection of surgical methods for poor organ perfusion caused by acute type A aortic dissection. The literature review findings suggest that central aortic repair can be employed for the treatment of acute type A aortic dissection with inadequate perfusion of the superior mesenteric artery. The superior mesenteric artery can be windowed and (/or) stented, followed by delayed aortic repair. Priority should be given to revascularization of the superior mesenteric artery, followed by central aortic repair. During central aortic repair, direct blood perfusion should be performed on the distal true lumen of the superior mesenteric artery, leading to resulting in favorable therapeutic outcomes. The research results indicate that even after surgical aortic repair, intestinal ischemic necrosis may still occur. In such cases, prompt laparotomy and necessary necrotic bowel resection are crucial for saving the patient’s life.

show abstract

Section: Superior Mesenteric Artery Revascularization Was Given Prior...mentioning

confidence: 99%