Subtypes of acute aortic dissection.
The technique of open distal anastomosis using deep hypothermic circulatory arrest was used in 69 cases of acute type A aortic dissection. These cases were subcategorized by site of intimal tear, which was found in the ascending aorta in 41 patients (60%), in the arch in 22 patients (32%), and in the descending aorta in 5 patients (7%). Clinical characteristics and complications are described for these subtypes. Hospital mortality, which was 14.5% overall for acute type A dissections, was 14.6% for ascending tears, 18.2% for arch tears, and 0% for descending aortic tears. Six-year survival was 69% +/- 15% for ascending tears, 69% +/- 22% for arch tears, and 80% +/- 25% for descending tears (mean +/- SEM, p = NS). A classification system for aortic dissection is proposed, based on both site of origin and propagation.
Lansman
S L
SL
Department of Cardiothoracic Surgery, Mount Sinai Medical Center, New York, New York 10029.
Galla
J D
JD
Schor
J S
JS
Ergin
M A
MA
Griepp
R B
RB
D000208:Acute Disease; D000784:Aortic Dissection / Q000145:classification / Q000401:mortality / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000145:classification / Q000401:mortality / Q000601:surgery*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D015996:Survival Rate