Purpose of review: Malperfusion is present in up to 40% of acute type A aortic dissections (ATAADs) and results in increased morbidity and mortality. This review presents different management strategies in patients with ATAAD and malperfusion to improve outcomes.
Recent findings: While the ideal management strategy of ATAAD complicated by malperfusion has yet to be determined, the literature provides evidence for additional techniques to be used in conjunction with central aortic repair to reduce mortality.
Summary: Recent findings support a role for initial reperfusion and delayed central aortic repair, although optimal management strategy remains debated.