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J Cardiothorac Surg. 2010 Jan 28;5:4. doi: 10.1186/1749-8090-5-4.

Acute Complex Type A Dissection associated with peripheral malperfusion syndrome treated with a staged approach guided by lactate levels.

Author information

1
Department of Cardiothoracic Surgery, Imperial College Healthcare NHS Trust, St Mary's Hospital, Praed Street, London W2 1NY, UK.

Abstract

Acute type A aortic dissection can be complicated by visceral malperfusion and is associated with a significant surgical morbidity and mortality. We describe a case of successful management of a complex acute type A dissection with mesenteric and lower limb ischemia treated with endovascular thoracic stenting and femoro-femoral crossover bypass grafting followed by aortic arch repair. To accomplish this, we applied a staged therapeutic approach using serial lactate measurements to assess the adequacy of peripheral perfusion and metabolic status prior to surgical repair of the proximal dissection.

PMID:
20109211
PMCID:
PMC2824630
DOI:
10.1186/1749-8090-5-4
[Indexed for MEDLINE]
Free PMC Article

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