DOI: 10.36347/sasjs.2021.v07i10.003

Pages: 536-541

Background: Acute aortic dissection is a medico-surgical emergency that is associated with a poor prognosis, especially when complicated by malperfusion syndrome. Purpose: The objective of our study was to assess the prognosis and management of aortic dissection complicated by malperfusion syndrome. Methods: Retrospective study from December 2017 to October 2019 including 4 patients hospitalized for aortic dissection with malperfusion syndrome operated at the Ibn Sina University Hospital. The diagnosis was made on clinical, biological and CT scans. Results: Patients’ mean age was 65.75 ±11,5 years with a sex ratio M / F of 1/3. Hypertension was the main risk factor and was found in all patients, only one of our patients was a smoker. The organs affected by malperfusion are divided as follows: Two (02) cases of lower limb malperfusion, two (02) cases of digestive malperfusion, one case of renal malperfusion, one case of cerebral malperfusion and one case of myocardial malperfusion. The management was surgical. Three patients underwent supracoronary tube placement and one patient underwent Bentall's procedure. Aorto-coronary bypass, an axillofemoral bypass and a cross bypass were performed to remove myocardial and lower limbs malperfusions. Mortality at one month was 50%, with one patient dying in-hospital from cardiogenic shock and one patient dying at one month from lower limb gangrene. Conclusion: Surgery is still relevant in managing aortic dissection associated with malperfusion. In our study, the survival at one month was 50%, suggesting the necessity to improving our management of aortic dissection when associated with malperfusion.