Management of acute type A aortic dissection with mesenteric malperfusion
10.3760/cma.j.cn112434-20221125-00363
- VernacularTitle:合并肠系膜灌注不良的急性Stanford A型主动脉夹层的治疗策略
- Author:
Yueyun ZHOU
1
;
Wei QIN
;
Jian LI
;
Cunhua SU
;
Xiaodi WANG
;
Fuhua HUANG
Author Information
1. 南京医科大学附属南京医院 南京市第一医院心胸血管外科 210006
- Keywords:
Acute type A aortic dissection;
Mesenteric malperfusion;
Revascularization-first strategy;
Hybrid operation room
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2023;39(10):605-609
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To summarize treatment strategies and outcomes of patient suffer from acute Stanford type A aortic dissection(ATAAD) with mesenteric malperfusion.Methods:We collected 13 patients with mesenteric malperfusion among 321 ATAAD patients underwent surgery at Nanjing First Hospital during January 2019 to September 2022. Characteristics of these patients were recorded. We analyzed their early and late clinical outcomes.Results:Two patients underwent revascularization-first strategy in hybrid operation room had no in-hospital mortality or complication related to mesenteric ischemia. There were 11 patients with central repair-first strategy. Eight patients appeared mesenteric complications and 2 of them needed extra gastrointestinal surgery. Six in-hospital mortality were recorded in central repair-first patients.Conclusion:We recommended revascularization-first strategy with followed central repair in hybrid operation room for patients suffered from ATAAD with mesenteric malperfusion. Those who underwent central repair-first strategy because of coronary artery or cerebral malperfusion and unstable hemodynamic needed percutaneous angiography of mesenteric artery.
