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

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


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.

Publication types

  • Case Reports

MeSH terms

  • Aneurysm, Dissecting / complications
  • Aneurysm, Dissecting / diagnostic imaging
  • Aneurysm, Dissecting / surgery*
  • Aortic Aneurysm, Thoracic / complications
  • Aortic Aneurysm, Thoracic / diagnostic imaging
  • Aortic Aneurysm, Thoracic / surgery*
  • Biomarkers / blood
  • Clinical Protocols
  • Femoral Artery / surgery*
  • Humans
  • Ischemia / diagnosis
  • Ischemia / etiology
  • Lactic Acid / blood
  • Leg / blood supply
  • Male
  • Middle Aged
  • Radiography
  • Stents
  • Syndrome
  • Treatment Outcome


  • Biomarkers
  • Lactic Acid