Progression of distal aorta after endovascular fenestration/stenting in acute type A aortic dissection with malperfusion syndrome

Ahmad, Rana‐Armaghan; Orelaru, Felix; Graham, Nathan J.; Titsworth, Marc; Monaghan, Katelyn; Wu, Xiaoting; Kim, Karen M.; Fukuhara, Shinichi; Patel, Himanshu J.; Deeb, G Michael; Yang, Bo

doi:10.1016/j.xjon.2023.02.015

Cited by 4 publications

(3 citation statements)

References 17 publications

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“…However, it is only considered as an alternative emergency intervention in cases of type-A (DeBakey I) dissections when surgical intervention is impossible due to the patient's condition. [4,7].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, surgical therapy is the gold standard of treatment; however, endovascular treatment alone or in combination with surgery may be considered. Especially, if true lumen collapse has evolved after surgical treatment or if the patient is un t for (re-) operation, endovascular techniques should be evaluated on an interdisciplinary basis [4,5].…”

Section: Introductionmentioning

confidence: 99%

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Endovascular fenestration in aortic type-A dissection with hepatic malperfusion syndrome: a case report

Weiss,

Jannusch,

Wilms

et al. 2024

Preprint

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Background: Fenestration of the dissection membrane in aortic dissection is a viable treatment option for abdominal malperfusion syndrome. While open surgical approaches are commonly chosen for type-A (DeBakey I and II) dissections, endovascular treatment gains importance in type-B dissections, particularly for patients unsuitable for surgery or in a combined approach. Case presentation: We present a case of an acute type-A (DeBakey I) aortic dissection in a patient who underwent a David-Procedure combined with a partial aortic arch replacement and was subsequently treated for hepatic malperfusion syndrome using an endovascular approach. Conclusions: The interdisciplinary approach led to a favorable clinical outcome, suggesting that endovascular treatment should be considered for patients with type-A dissection and abdominal malperfusion syndrome.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Endovascular fenestration in aortic type-A dissection with hepatic malperfusion syndrome: a case report

Weiss,

Jannusch,

Wilms

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…The mortality rate increases by 1% within 1 h after onset, and if medical intervention is not performed in time, the mortality rate within 48 h can be as high as 30-50% [1]. Approximately 40% of patients with ATAAD experience malperfusion syndrome (MPS) [2], resulting in a total mortality rate of up to 45% [3]. Malperfusion is reported as a complication associated with ATAAD in 3.7% of cases [4].…”

Section: Introductionmentioning

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

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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.

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Association of intraoperative transfusion of blood products with postoperative outcomes and midterm survival in acute type A aortic dissection repair

Norton,

Arora,

Cangut

et al. 2024

JTCVS Open

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Progression of distal aorta after endovascular fenestration/stenting in acute type A aortic dissection with malperfusion syndrome

Cited by 4 publications

References 17 publications

Endovascular fenestration in aortic type-A dissection with hepatic malperfusion syndrome: a case report

Endovascular fenestration in aortic type-A dissection with hepatic malperfusion syndrome: a case report

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

Association of intraoperative transfusion of blood products with postoperative outcomes and midterm survival in acute type A aortic dissection repair

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