Organ Malperfusion and Mortality in Acute Type 1 Aortic Dissection with Iliac Extension: A Retrospective Single-Center Study Focused on Mesenteric Malperfusion and the Source–Clearance Hypothesis

Background/Objectives: Mesenteric malperfusion is the most lethal and least recognizable complication of acute type A aortic dissection. This study aimed to examine organ-specific malperfusion patterns and 30-day mortality in acute type 1 aortic dissection with iliac extension, and to evaluate whether the lactate-to-albumin ratio (LAR) and superior mesenteric artery (SMA) origin pattern add predictive value for mesenteric malperfusion syndrome within a “source–clearance” framework.