Organ Malperfusion in Patients with Acute Aortic Dissection : Pathophysiology and Treatment

Abstract

Malperfusion of aortic branch vessels is a common, but catastrophic complication of acute aortic dissection associated with poor outcomes. Branch vessel obstruction causing organ malperfusion may be static, dynamic, or a combination of both. Patients with malperfusion are more likely to have an entry tear in the aortic arch and distal extension of dissection. Coronary, cerebral, and mesenteric malperfusion in particular increase the risk of death. Thus, treatment strategies that prioritize revascularization of the ischemic organ are important for such organ malperfusion. A therapeutic approach by an aortic team may facilitate early organ revascularization, leading to improved outcomes.