The present situation and progress of treatment of acute type A aortic dissection with organ malperfusion syndrome / 中华胸心血管外科杂志

ABSTRACT

With the development of brain protection, management of aortic root and arch lesions, the surgical mortality of acute type A aortic dissection is gradually decreasing, and malperfusion syndrome(MPS) is becoming increasingly prominent as A major problem affecting the short-term efficacy of acute type A aortic dissection. Aortic dissection may lead to poor perfusion of various organs, among which brain, heart, abdominal organs, kidney, lower limbs and spinal cord are the most prominent, with a total incidence of about 30%. There was a significant difference in surgical mortality between aortic dissection with or without organ MPS. As the number of organs involved increased, the mortality rate increased significantly. Abdominal viscera, especially mesenteric malperfusion is the key point of the surgical attention. At present, the contents worth discussing are as follows (1) the definition of organ malperfusion syndrome of aortic dissection; (2) accurate classification or classification of poor perfusion of each system; (3)establish a more accurate scoring system for preoperative risk assessment of aortic dissection; (4)Thoracic Endovascular Aortic Repair priority or time priority or individualization should be adopted for the management of organ perfusion syndrome.