Mesenteric ischemia in acute aortic dissection

  title={Mesenteric ischemia in acute aortic dissection},
  author={Kazumasa Orihashi},
  journal={Surgery Today},
Mesenteric ischemia complicated by acute aortic dissection (AAD) is uncommon, but serious, as there is no established treatment strategy and it can progress rapidly to multi-organ failure. Diagnosing mesenteric ischemia before necrotic change is difficult, not only for primary care physicians, but even for gastrointestinal or cardiovascular surgeons as it can occur at any time during surgery. Thus, measures need to be in place at the bedside to enable us to obtain information on visceral… 

Mesenteric ischemia in acute aortic dissection

  • K. Orihashi
  • Medicine
    General Thoracic and Cardiovascular Surgery
  • 2018
Several diagnostic modalities such as ultrasound and near-infrared spectroscopy are reviewed, as well as surgical treatments for assessing mesenteric ischemia, to help guide treatment strategies.

Arterial Endovascular Interventions in Acute Mesenteric Ischemia

The endovascular approach to treatment of AMI will depend on the underlying etiology and the acuity of patient presentation, presence, or absence of bowel infarction; patient stability; and availability of a hybrid operating room will influence the treatment plan of a patient with AMI.


Physicians should be aware of AMI as a possible cause of abdominal pain, especially in elderly patients with cardiovascular comorbidities, and contrast enhanced CT should be the first-line imaging modality for diffe­rential diagnosis.

Usefulness of transesophageal echocardiography in the evaluation of celiac trunk and superior mesenteric artery involvement in acute aortic dissection.

  • S. MoralG. Avegliano A. Evangelista
  • Medicine
    Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
  • 2020

Impact of the collateral network on central-repair-first strategy in superior mesenteric artery occlusion with type A acute aortic dissection

In patients with non-enhanced peripheral branches, a more invasive assessment should be considered before central aortic repair, and peripheral-reperfusion-first strategy may be required.

Successful visceral revascularization after acute type A aortic dissection: How to predict visceral ischemia

Visceral ischemia should be kept in mind as a possible complication in patients with acute aortic dissection, and this complication can be expected by monitoring of base excess and lactate serum level.

Critical Malperfusion Caused by Central Aortic Repair for Acute Aortic Dissection: A Case Report

We encountered a case of hepatic malperfusion resulting from central repair for Stanford type A acute aortic dissection (AAD). A 78-year-old woman had AAD, for which ascending aortic repair was

Transarterial Embolization With Complementary Surgical Ligation of Gastroduodenal Artery for Ruptured Pancreaticoduodenal Artery Aneurysm

This case proposed that visceral arterial malperfusion due to acute aortic dissection can cause PDAA in the early postoperative period and transarterial embolization with complementary clamping or ligation of the gastroduodenal artery for ruptured PDAA is less invasive and can control hemorrhage.

Liver and Gallbladder Infarction as a Complication of Acute Aortic Dissection in the Splenomesenteric Trunk

Interventional radiology effectively detected the cause of ischemia and enabled treatment of the visceral artery malperfusion of a splenomesenteric trunk in a case of type B aortic dissection with isolated liver and gallbladder infarction.

Minimally invasive acute care surgery.



Perioperative diagnosis of mesenteric ischemia in acute aortic dissection by transesophageal echocardiography.

  • K. OrihashiT. SuedaK. OkadaK. Imai
  • Medicine
    European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
  • 2005

Successful repair of mesenteric ischemia in acute type A aortic dissection

A 64-year-old man with acute type A aortic dissection has superior mesenteric artery occlusion and marked metabolic acidosis, and central repair was carried out by bypass grafting from the left external iliac artery to the superior mesEnteric artery.

A case of acute type B aortic dissection: limited role of laboratory testing for the diagnosis of mesenteric ischemia.

  • K. AkutsuH. Matsuda S. Takeshita
  • Medicine
    Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia
  • 2007
A 30-year-old man with severe back and abdominal pain was referred to the authors' hospital because of a recurrence of acute type B aortic dissection, and Operative findings confirmed a pale shrunken intestine, indicative of mesenteric ischemia.

Percutaneous management of ischemic complications in patients with type-B aortic dissection.

Endovascular methods offer a less-morbid nonsurgical treatment alternative for patients with acute complicated type-B aortic dissection, with no 30-day mortality, in-hospital mortality, or paraplegia.

Delayed visceral malperfusion after Bentall procedure for type A acute aortic dissection.

Although organ malperfusion persisting after proximal aortic graft replacement despite redirecting blood flow into the true lumen is rare, close observation remains imperative after central repair of type A dissection.