A New Aortic Arch Dissection Classification: The Fuwai Classification

Authors

Juntao Qiu
Xinjin Luo
Jinlin Wu
Wei Pan
Qian Chang
Xiangyang Qian
Xiaogang Sun
Bo Wei
Liang Zhang
Shen Liu
Wenxiang Jiang
Cuntao Yu

Publication Date

1-1-2021

Journal

Frontiers in Cardiovascular Medicine

DOI

10.3389/fcvm.2021.710281

PMID

34595220

PMCID

PMC8476803

PubMedCentral® Posted Date

9-14-2021

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

aortic arch dissection, classification system, clinical characteristic, mortality, surgery

Abstract

Aims: We describe a new aortic arch dissection (AcD) classification, which we have called the Fuwai classification. We then compare the clinical characteristics and long-term prognoses of different classifications.

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

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. The highest operation proportion of Cp, Ct and Cd were partial arch replacement, total arch replacement, and TEVAR. The surgical mortality in type Ct was higher compared to type Cd (Ct vs. Cd = 9.38 vs. 1.69%, p < 0.01) and type Cp (Ct vs. Cp = 9.38 vs. 1.85%, p = 0.06). There was no difference in surgical mortality of type Cp and Cd (p = 0.93). There were no significant differences in the long-term survival rates (p = 0.38) and free of aorta-related re-operations (p = 0.19).

Conclusion: The Fuwai classification is used to distinguish different AcDs. Different AcDs have different surgical mortality and use different operation methods, but they have similar long-term results.

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