Uchida K, et al. - In view of the significance of the control of malperfusion in improving the outcomes of surgery for type A acute aortic dissection, researchers revised their treatment strategy to reperfuse each ischemic organ before central repair. The current early reperfusion strategy comprised of percutaneous coronary artery intervention for coronary malperfusion, direct surgical fenestration for carotid artery occlusion, active perfusion of the superior mesenteric artery for visceral malperfusion, and external shunting from brachial artery to the femoral artery for lower limb ischemia. As per findings, the outcomes of surgery for type A acute aortic dissection with malperfusion could be improved with this strategy. In irreversibly damaged patients, the strategy allowed avoiding unproductive central repair operations.