Augoustides et al reported a clinical classification of patients with an acute Type A aortic dissection. The authors are from the University of Pennsylvania in Philadelphia.
Patient selection: acute type A aortic dissection
Parameters:
(1) hemodynamic status and generalized perfusion
(2) perfusion in branch arteries
Generalized Perfusion
Localized Perfusion
Class
hemodynamically stable
no local ischemia
a
hemodynamically stable
local ischemia present
b
circulatory collapse with generalized ischemia
no local ischemia
c
circulatory collapse with generalized ischemia
local ischemia present
b + c
Signs of local ischemia: stroke, renal dysfunction, mesenteric ischemia, ischemic extremity.
Circulatory collapse may be consequent to cardiac tamponade, coronary dissection, acute aortic regurgitation and/or aortic rupture.
The prognosis worsens with higher classes.
Class
All Cause Mortality
a
3.1%
b
26%
c
18%
b + c
40%
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