Impact of persistent malperfusion syndrome following central repair of acute type A aortic dissection on early outcomes

We investigated impact of persistent malperfusion syndrome (MPS) following central repair of acute type A aortic dissection (ATAAD) on outcomes. Thirty patients who underwent central repair for ATAAD with MPS were included. Patients were divided into two groups : 23 patients without MPS following central repair (No-MPS group) and 7 with MPS (Persistent-MPS group). The mean age was 66.8 ± 9.6 and 59.4 ± 13.4 years in the No-MPS and Persistent-MPS groups, respectively (P = 0.176). Preoperative MPS included the left coronary artery (n = 3), brain (n = 3), abdomen (n = 7), and extremities (n = 11) in the No-MPS group. In the Persistent-MPS group, the right coronary (n = 1), brain (n = 2), abdomen (n = 3), and extremities (n = 5) were observed. In the No-MPS group, one patient died of extensive cerebral infarction (4.3%). In the Persistent-MPS group, 2 patients died of sepsis and multi-organ failure, respectively (28.6%) (P = 0.061). The Persistent-MPS group had more patients requiring hemodialysis than the No-MPS group (P = 0.009). Three patients underwent intestinal resection due to persistent MPS (P < 0.001). Persistent MPS following central repair for ATAAD significantly contributed to outcomes.