Management of Acute Type A Dissection Complicated with Acute Mesenteric Ischemia

Tomonobu Abe, Akihiko Usui

Research output: Contribution to journalArticlepeer-review


Acute mesenteric ischemia as malperfusion syndrome associated with acute aortic dissection is a difficult situation. The incidence is approximately 3~4% in acute type A dissection. Traditionally, most of these patients underwent immediate simple central aortic repair expecting that mesenteric artery obstruction and intestinal ischemia would be resolved by simple central aortic repair. However, short term mortality has been reported very high in this strategy. With the aid of rapidly progressing imaging techniques and newer endovascular repair techniques, results seem to be improving in recent years. Newer management strategy include aggressive and patient specific revascularization to the mesenteric arteries, delayed central aortic repair, and meticulous intensive care. Diagnosis and management of this condition require high level of expertise. Cardiac surgeons, vascular surgeons, interventional radiologists, gastroenterologists, general surgeons, anesthesiologists, intensivists must corporate to save these patients' lives. Since this is a relatively rare condition, scientific evidence is insufficient to make robust recommendations. Further studies are warranted.

Original languageEnglish
Pages (from-to)605-611
Number of pages7
JournalKyobu geka. The Japanese journal of thoracic surgery
Issue number8
Publication statusPublished - 01-07-2017

All Science Journal Classification (ASJC) codes

  • Medicine(all)


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