Trans-pericardal Color Doppler Ultra Sound to Assess Blood Flow in the Visceral Branches during Type A Dissection Procedures Complicated with Mesenteric Malperfusion.

Aortic dissection is a complex disease associated with high mortality and morbidity. Among the different possible clinical presentations, type A aortic dissection complicated at the onset by mesenteric malperfusion is characterized by poor outcome compared with patients not presenting such complication. We report the case of a patient with acute type A aortic dissection presenting with mesenteric malperfusion, in whom trans-pericardial color Doppler ultrasound (CDUS) examination was used to assess intraoperative and postoperative blood flow in the mesenteric artery. Trans-pericardial CDUS is demonstrated as a fast and simple diagnostic method with a good matching compared with contrast-enhanced computed tomography scan imaging, if correctly approached. We believe that this technique could be an important adjunctive tool for the intraoperative and perioperative management and decision-making in all patients with type A dissection presenting with mesenteric ischemia.