Nakai C, Izumi S, Haraguchi T, et al. - Researchers examined patients with acute type-A aortic dissection (AADA) complicated by malperfusion syndrome (MPS) in order to determine if the timing of operative treatment and the location of malperfusion are factors in determining outcomes. From August 2003 to May 2019, they identified a total of 331 AADA patients treated surgically. Among these patients, 84 (25%) presented with preoperative MPS. The early mortality rates did not differ significantly between patients with immediate and later aortic repair. The only predictor of early mortality was preoperative coronary malperfusion. Overall findings suggest worsened long-term outcomes in patients undergoing aortic repair for AADA with preoperative MPS in correlation with preoperative coronary malperfusion and shock on arrival, however, a significant improvement in their long-term outcomes was noted when an operation was conducted within 5 hours of the onset of symptoms.