A Novel Approach to the Treatment of Distal Malperfusion Secondary to Ascending Aortic Dissection

P>Acute Type A dissection is a surgical emergency. The presence of visceral and extremity malperfusion syndromes increases perioperative mortality twofold. On occasion, significant malperfusion may best be addressed in a staged fashion with preliminary attention to specific vascular beds with delayed repair of the dissection itself. We present a subacute Type A dissection associated with malperfusion of multiple vascular beds (mesenteric, renal, and iliofemoral) managed with a complication-specific approach utilizing endovascular thoracoabdominal aortic repair prior to ascending repair. (J Card Surg 2010;25:220-222).