Ghoreishi et al reported a Mortality Risk Score (MRS) for predicting operative mortality of a patient with Type A aortic dissection. The authors are from the University of Maryland.
Patient selection: acute Type A (Stanford) aortic dissection
Parameters:
(1) deBakey type
(2) cardiogenic shock
(3) mortality risk score (MRS)
DeBakey Type
Cardiogenic Shock
Mortality Risk Score
Management
Type 2
NA
NA
replace ascending aorta
Type 1
yes
NA
replace ascending aorta
Type 1
no
< 7
replace ascending aorta
Type 1
no
7 to 20
replace ascending aorta
Type 1
no
> 20
consider hybrid approach
A hybrid approach may include:
(1) thoracic endovascular aortic repair (TEVAR) or fenestration. Once malperfusion has been treated then replace ascending aorta
(2) ascending aortic stent if anatomy is suitable
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