Assessment of Malperfusion Syndrome in Aortic Dissection: Defining an Aortic Dissection Lab Panel

Aortic dissection (AD) is a devastating disease process in which the intimal wall of the aorta tears, resulting in a false channel to which blood can enter. As blood enters this false channel, the dissection of the tunica intima away from the tunica media continues to grow, compressing and limiting the flow of blood through smaller arterial branches and possibly even shearing some of them off. The rate of mortality from AD has been found to be as high as 45% and one of the biggest factors in predicting that mortality is the presence of malperfusion syndrome. In this article we examine the effects of malperfusion syndrome on survivability and the utilization of various laboratory investigations in determining the severity of malperfusion syndrome. The goal of this article is to establish a standard aortic dissection lab panel that should be drawn on every patient suspected of having an AD as soon as they present for diagnosis and treatment in an attempt to provide the cardiothoracic and vascular surgeon with the information necessary to plan the required type and timing of repair