Outcomes of patients with acute type A aortic dissection and concomitant lower extremity malperfusion

A novel nomogram model to predict in-hospital mortality in patients with acute type A aortic dissection after surgery

“…Extra-anatomic bypass grafting during aortic repair can effectively solve the problem [ 14 ]. The study by Natour et al noted asymptomatic graft occlusion in all follow-up patients who underwent extra-anatomic bypass [ 15 ], which may be attributed to competing blood flow from a remodeling autologous arterial system. However, it is interesting that this does not affect the long-term survival rate of patients, which may suggest that rapid restoration of perfusion in lower limb ischemia can achieve good results.…”

Painless aortic dissection with catastrophic consequences presenting as sudden loss of consciousness with no prodromal symptoms

“…Aortic dissections occur due to the gradual deterioration of the cells comprising the aortic wall. This deterioration typically takes place silently over many years until the weakened section of the aorta eventually tears, resulting in a dissection [ 5 ] . Patients with acute aortic dissection usually have hypertension, but as the condition progresses, patients can present with hypotension [ 6 ] .…”

Lower-extremity malperfusion syndrome in patients undergoing proximal aortic surgery for acute type A aortic dissection

“…Unlike other studies that identify PVD to be associated with LEM, our study did not find the incidence of PVD was significantly different between groups. 1 However, when LEM was present, PVD was found to be associated with revascularization.…”

“…Acute type A aortic dissection (TAAD) is typically managed with emergency surgery with mortality outcomes ranging from 15% to 30%. 1 , 2 Perioperative outcomes for TAAD are particularly worse in the setting of malperfusion syndromes, with mortality rates increasing up to 43%. 3 , 4 , 5 Concomitant lower-extremity malperfusion (LEM) occurs in less than 20% to 30% of patients presenting with TAAD, but the presence of preoperative limb ischemia increases the risk of mortality up to 2-fold.…”

“… 3 , 4 , 5 Concomitant lower-extremity malperfusion (LEM) occurs in less than 20% to 30% of patients presenting with TAAD, but the presence of preoperative limb ischemia increases the risk of mortality up to 2-fold. 1 , 5 , 6 , 7 Although LEM has been identified as an important determinant of mortality in TAAD repair, there are few data comparing outcomes and optimal management in this complex situation.…”