Penn classification in acute aortic dissection patients

Pisano, Calogera; Balistreri, Carmela Rita; Torretta, Federico; Capuccio, Veronica; Allegra, Alessio; Argano, Vincenzo; Ruvolo, Giovanni

doi:10.1080/ac.71.2.3141855

Cited by 21 publications

(11 citation statements)

References 9 publications

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“…29 Previous studies have demonstrated the utility of Penn classification for acute dissections in predicting perioperative outcomes. [30][31][32] However, in our study, mortality numbers observed in Class Aa, Ab, Ac, and Abc patients were too low to assess the relationship between Penn classification and mortality. Although the sample size of patients with aortic dissection in our series was small, to substantially make any conclusions, our results raise an important argument suggesting that perhaps surgical treatment may have a role in low-risk patients, regardless of their age.…”

Section: Discussioncontrasting

confidence: 56%

Proximal aortic surgery in the elderly population: Is advanced age a contraindication for surgery?

Wanamaker

Hirji

Val

et al. 2019

The Journal of Thoracic and Cardiovascular Surgery

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Section: Discussioncontrasting

confidence: 56%

Proximal aortic surgery in the elderly population: Is advanced age a contraindication for surgery?

Wanamaker

Hirji

Val

et al. 2019

The Journal of Thoracic and Cardiovascular Surgery

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“…Ultimately, most patients with severe ischemia or malperfusion were not enrolled in this study. The results were appropriate for patients classified as Penn class Aa but are not a guideline to those who are Penn class Ab and Ac [22].…”

Section: Limitationsmentioning

confidence: 93%

Impact of autologous platelet rich plasma use on postoperative acute kidney injury in type A acute aortic dissection repair: a retrospective cohort analysis

Tong

Cao

Liu

et al. 2021

J Cardiothorac Surg

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Background Perioperative coagulopathy and blood transfusion are common in patients undergoing Stanford type A acute aortic dissection (AAD) repair. The autologous platelet-rich plasmapheresis (aPRP) technique is a blood conservation approach to reduce blood transfusions and morbidity in patients at high risk of bleeding. The purpose of this study was to analyze the effect of aPRP on outcomes, especially in postoperative acute kidney injury (post-AKI), in patients undergoing AAD surgery. Methods Six hundred sixty patients were divided into aPRP and non-aPRP groups according to aPRP use. The primary endpoint was the difference in the incidence of post-AKI between two groups. The secondary endpoints were risk factors for post-AKI and to assess clinical outcomes. The risk factors associated with post-AKI were calculated, and all outcomes were adjusted by propensity-score matching analysis. Results A total of 272 patients (41.2%) received aPRP, whereas 388 were in the non-aPRP group. Compared to non-aPRP group, the occurrence of post-AKI increased by 14.1% (p = 0.002) and 11.1% (p = 0.010) with and without propensity adjustment in the aPRP group, respectively. The aPRP group required fewer intraoperative transfusions (p < 0.05) and shortened the duration of mechanical ventilation (p < 0.05) than those in the non-aPRP group. Multiple regression analyses showed that aPRP (odds ratio: 1.729, 95% confidence interval: 1.225–2.440; p < 0.001) was one of the independent risk factors for post-AKI. Conclusions The use of aPRP significantly reduced intraoperative blood transfusions and decreased postoperative mortality-adjusted mechanical ventilation. However, aPRP use was independently associated with an increased hazard of post-AKI after adjusting for confounding factors.

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“…The Penn classification is a recent method of categorizing type A dissections by their clinical presentation [24][25][26]. Class Aa is characterized by the absence of branch vessel malperfusion or circulatory collapse, and class Ab by symptoms or signs of localized organ ischaemia.…”

Section: Introductionmentioning

confidence: 99%

Acute type A aortic dissection – a review

Guðbjartsson

Ahlsson

Geirsson

et al. 2019

Scandinavian Cardiovascular Journal

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Acute type A aortic dissection (ATAAD) is still one of the most challenging diseases that cardiac surgeons encounter. This review is based on the current literature and includes the results from the Nordic Consortium for Acute Type-A Aortic Dissection (NORCAAD) database. It covers different aspects of ATAAD and concentrates on the outcome of surgical repair. The diagnosis is occasionally delayed, and ATAAD is usually lethal if prompt repair is not performed. The dynamic nature of the disease, the variation in presentation and clinical course, and the urgency of treatment require significant attentiveness. Many surgical techniques and perfusion strategies of varying complexity have been described, ranging from simple interposition graft to total arch replacement with frozen elephant trunk and valve-sparing root reconstruction. Although more complex techniques may provide long-term benefit in selected patients, they require significant surgical expertise and experience. Short-term survival is first priority so an expedited operation that fits in with the surgeon's level of expertise is in most cases appropriate. ARTICLE HISTORY Definitions and classification systemsDissection of the aorta occurs when the aortic media is separated, usually by pulsatile flow that penetrates the intimal layer of the aortic wall [14] (Figure 1(b)). This allows blood to flow between the layers of the aortic wall, forcing the layers apart, creating a false lumen parallel to the native (i.e. true) aortic lumen (Figure 1(b)). Consequently, the false lumen can propagate in both directions from the tear of intima and affect most of its distal branches, including the coronary, cerebral, and mesenteric arteries [15]. Another-but less common-CONTACT Tomas Gudbjartsson

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Penn classification in acute aortic dissection patients

Cited by 21 publications

References 9 publications

Proximal aortic surgery in the elderly population: Is advanced age a contraindication for surgery?

Proximal aortic surgery in the elderly population: Is advanced age a contraindication for surgery?

Impact of autologous platelet rich plasma use on postoperative acute kidney injury in type A acute aortic dissection repair: a retrospective cohort analysis

Acute type A aortic dissection – a review

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