CONCLUSIONS
The revascularization-first strategy in AAD with mesenteric malperfusion was acceptable and may achieve favorable results. However, the appropriate strategy for severely complicated cases, such as those with other-major organ malperfusion or having hemodynamically unstable status, remains controversial. Close evaluation of mesenteric perfusion using multiple modalities and prompt revascularization are mandatory in these complicated cases. Moreover, IVR at the hybrid OR enables immediate revascularization, followed by central aortic repair. A hybrid OR provides an ideal environment where interventional radiology and surgery can be performed at the same time for the aortic team of cardiac surgeons, radiologists, and anesthesiologists.
Acknowledgements We thank the Honyaku Center for reviewing and editing the manuscript. We also thank our colleagues for their helpful comments.
Disclosure Statement There are no conflicts of interest to declare.
Funding statement: We did not receive any financial support for this study.