When left untreated, AAD can rapidly progress to a highly lethal condition, due to rupture, tamponade, myocardial infarction, or aortic valve insufficiency ( 9, 10). Several well-described risk factors contribute to this condition, including advanced age, male gender, hypertension, aortic dilatation, connective tissue disorders, and bicuspid aortic valve ( 3, 5– 8). AAD is part of the spectrum of acute aortic syndromes (AAS), defined as a tear in the intimal/media layers, which creates a new lumen (false lumen), where the blood flows between the dissecting membrane and the adventitial layer. AAD is associated with a high mortality rate: ~1% of patients die/h ( 1– 4). Preliminary findings supported the usefulness of this classification for the decision-making process and subsequent treatments.Īcute aortic dissection (AAD) is a complex disease with a reported annual incidence of 2–15/100,000 inhabitants. Type C was treated with significantly more endovascular or hybrid interventions (37%) than in types A (3%) and B (20%) ( p < 0.001).Ĭonclusion: The new AAD classification was feasible, and type C was easily identified (“non-A, non-B”). MPS occurred in 39, 24, and 29% in type A, B, and C, respectively. Results: According to the new classification, we identified 152 type A dissections (92 A0, 11 A1, 38 A2, 11 A3) 50 type B (38 B0, 5 B1, 6 B2, 1 B3) and 24 type C (17 C0, 6 C2, 1 C3). AAD features were assessed and correlated to patient outcomes. AADs were reclassified with a new classification scheme that included three aortic dissection types (A, involving at least the ascending aorta B, involving exclusively the descending aorta and C, involving the aortic arch with/without the descending aorta) and four malperfusion grades (0: no MPS 1: dynamic MPS 2: static MPS 3: static and dynamic MPS). Materials and Methods: We retrospectively reviewed pre-therapy CT angiograms of 226 consecutive patients (mean ± SD age: 64 ± 12 years) with AAD. The proposed classification was evaluated retrospectively in a large population. Objectives: To report a new classification scheme for acute aortic dissection (AAD) that considers the aortic arch as a separate entity and integrates patterns of malperfusion syndrome (MPS). 4Department of Heart and Vessels, Lausanne University Hospital (CHUV), Lausanne, Switzerland.3Department of Radiology, Kantonsspital Frauenfeld, Frauenfeld, Switzerland. 2Faculty of Biology and Medicine (FBM), University of Lausanne (UNIL), Lausanne, Switzerland.1Department of Diagnostic and Interventional Radiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland.Qanadli 1,2 * † Sonaz Malekzadeh 1 † Nicolas Villard 1 Anne-Marie Jouannic 1 Daniel Bodenmann 3 Piergiorgio Tozzi 2,4 David C.
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