Recommendations for Management of Malperfusion

Referenced studies that support the recommendations are summarized in the Online Data Supplement.

COR	LOE	RECOMMENDATIONS
1	B-NR	1. In patients with acute type A aortic dissection presenting with renal, mesenteric, or lower extremity malperfusion, it is recommended to proceed to immediate operative repair of the ascending aorta.1,2
2a	C-LD	2. In patients with acute type A aortic dissection presenting with clinically significant mesenteric (celiac, SMA) malperfusion, either immediate operative repair of the ascending aorta or immediate mesenteric revascularization via endovascular or open surgical intervention by those with this expertise before ascending aortic repair is reasonable.3–6