#DEFINITION OF AORTIC ARCH FREE#

Except for these two classifications, all other AcDs are denoted as Fuwai type Ct (t is short for total or transverse). If the aortic dissection only involves the distal arch, it is denoted as Fuwai type Cd (d is short for distal). If the aortic dissection only involves the proximal arch, it is denoted as Fuwai type Cp (p is short for proximal). The distal aortic arch is the proximal end of the left common carotid artery and includes the distal end of the left subclavian artery. The proximal aortic arch is the proximal end of the innominate artery and includes the distal end of the left common carotid artery.

The Fuwai classification subdivides the aortic arch into the proximal aorta, distal aorta, and total aorta. The Fuwai classification is based on dissection propagation. Methods Fuwai Classification of Aortic Arch Dissection We also explored whether the new aortic dissection classification could help in the selection of operation methods. This study aimed to compare the clinical characteristics and long-term prognosis in different types of AcD. Therefore, we propose the Fuwai classification for AcD to distinguish differences in aortic arch involvement and guide in the selection of an operation method ( 7). There should be a classification corresponding to operation methods for AcD patients. At present, various new aortic arch operation technologies are emerging, such as hybrid technique, endovascular thoracic branched stent, etc ( 6). However, the traditional classification was not able to respond to operation methods for AcD patients. Partial arch replacement and total arch replacement techniques have different prognoses ( 5). This naming method was not widely accepted, and the therapeutic strategy did not reach a conclusion, partly because there was no unified definition.Īortic arch surgery is complicated and high risk. Von Segesser firstly defined the distal aortic arch dissection as non-A-non-B dissection ( 4). However, these two classifications have unclear definitions for aortic arch dissection (AcD), especially when the distal aortic arch is involved. The DeBakey and Stanford classifications are the most commonly used methods to categorize aortic dissection. Different AcDs have different surgical mortality and use different operation methods, but they have similar long-term results.Īortic dissection is a life-threatening medical emergency with a 10% to 20% risk of in-hospital mortality ( 1– 3).

#DEFINITION OF AORTIC ARCH FREE#

There were no significant differences in the long-term survival rates ( p = 0.38) and free of aorta-related re-operations ( p = 0.19).Ĭonclusion: The Fuwai classification is used to distinguish different AcDs. There was no difference in surgical mortality of type Cp and Cd ( p = 0.93). The surgical mortality in type Ct was higher compared to type Cd (Ct vs. The highest operation proportion of Cp, Ct and Cd were partial arch replacement, total arch replacement, and TEVAR. Results: In total, 1,063 AcD patients were enrolled from 2010 to 2015: 54 patients were type Cp, 832 were type Ct, and 177 were type Cd. Kaplan-Meier was used for the analysis of long-term survival and survival free of reoperation.

The Chi-square test was adopted for the pairwise comparison among the three types. All other AcD surgeries are defined as type Ct. Type Cd is defined as the left subclavian artery or combined with the left carotid artery involved. Type Cp is defined as the innominate artery or combined with the left carotid artery involved. AcD procedures are divided into three types: Fuwai type Cp, Ct, and Cd. Methods: All AcD patients who underwent surgical procedures at Fuwai Hospital from 2010 to 2015 were included in the study. We then compare the clinical characteristics and long-term prognoses of different classifications.

4Department of Cardiovascular Surgery, Peking University International Hospital, Beijing, ChinaĪims: We describe a new aortic arch dissection (AcD) classification, which we have called the Fuwai classification.

3Department of Cardiovascular Surgery, Institute of Heart, Lung and Blood Vessel Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

2Department of Anesthesia, Baylor College of Medicine, Texas Heart Institute, Houston, TX, United States.

1Department of Cardiovascular Surgery, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.

Juntao Qiu 1 †, Xinjin Luo 1 †, Jinlin Wu 1, Wei Pan 2, Qian Chang 1, Xiangyang Qian 1, Xiaogang Sun 1, Bo Wei 1, Liang Zhang 3, Shen Liu 4, Wenxiang Jiang 1 and Cuntao Yu 1 *

Definition of aortic arch