AORTIC DISSECTION

DISSECTING ANEURYSMS OF THE AORTA or
AORTIC DISSECTION

CLASSIFICATION

DeBakey classified aortic dissections into types I, II, and III :-
• Type I dissection the tear site originates in the ascending aorta, usually just above the left main coronary artery, and the dissection continues distally into the descending or abdominal aorta.
• Type II dissection the tear site is in a similar location in the ascending aorta, but the dissection stops distally at the innominate artery.
• Type III dissection the tear site originates in the upper descending thoracic aorta, just distal to the subclavian artery; in type IIIA the dissection is localized in the thoracic aorta, and in type IIIB the dissection proceeds into the abdominal aorta.
The Stanford classification proposed by Miller is based on the clinical course and the surgical significance of the dissection.
• Stanford type A dissection includes any dissection involving the ascending aorta (DeBakey types I and II)
• Stanford type B dissection involves only the descending aorta (DeBakey type III).
Borst and associates advocated a more simplified, descriptive classification. In this system
• Proximal aortic segment (ascending and transverse arch)
• Distal aortic segment (descending thoracic and thoracoabdominal)
Aortic dissection also is categorized based on the time elapsed since the initial event.
• Acute within the first 14 days following the initial tear.
• Subacute period from day 15 through 60 after the initial event.
• Chronic phase after day 60 (some consider chronic >14 days without subacute phase).





DeBakey s classification of dissecting aortic aneurysms: Type I, Type II, and Type III -1-