Malperfusions in Acute Type B Aortic Dissection—Predictors of Outcomes

The Society of Thoracic Surgeons/American Association for Thoracic Surgery clinical practice guidelines on the management of type B aortic dissection

“…The 30-day mortality rate was 17.1%, with 2 deaths due to bowel infarction, and 3 patients underwent bowel resection without further visceral revascularization. 58 Three other series of complicated TBAD reported overall adjunctive branch stenting rates of 13.7% to 22%, including visceral branches and no cases of bowel resection or bowel-related mortality. 38,56,59 In the most recent IRAD report, of the 51 acute TBAD patients with visceral ischemia, 63% underwent TEVAR, 31% underwent fenestration, and 33% underwent branch vessel stenting.…”

“…Of those studies that detail malperfused regions, the proportion of visceral malperfusion ranges from 7.6% to 60%. 38,[55][56][57][58][59][60] Two series reported no need for adjunctive branch stenting or fenestration, but one reported a post-TEVAR colon resection, 55 and the other reported a death at postoperative day 11 from persistent visceral ischemia. 57 A report from 2 high-volume European centers described 41 complicated TBAD patients, with an overall 41% branch vessel stenting rate.…”

Re-expansion of Thrombosed False Lumen after Aortic Dissection Due to Collateral Retrograde Flow from the Aortic Branches

“…1,2) However, surgical treatment is necessary for patients with complications, such as malperfusion syndrome, progression of dissection, enlarging aneurysm, and inability to control blood pressure or symptoms because its prognosis is extremely poor. 3,4) Re-expansion of the thrombosed false lumen after aortic dissection caused by collateral retrograde flow from the aortic branches has rarely been reported. The optimal management for this condition is unknown.…”

“… 1 , 2 ) However, surgical treatment is necessary for patients with complications, such as malperfusion syndrome, progression of dissection, enlarging aneurysm, and inability to control blood pressure or symptoms because its prognosis is extremely poor. 3 , 4 )…”

A Mock Circulation Loop for In Vitro Hemodynamic Evaluation of Aorta: Application in Aortic Dissection

“…4 On the other hand, one of the most lethal complications is the malperfusion syndrome with a reported mortality rate of 25% to 62%, 5,6 which involves visceral or lower extremity, the TL compressed by further expansion of the FL can also make the bloodstream in the TL diminish and thus cause the limb ischaemic. 7,8 Visualization of local hemodynamics of AD and visceral branches is essential to understand the blood perfusion environment of this disease.…”