Describe the Stanford classification.
Stanford type A aortic dissection: any dissection involving the ascending aorta (defined as proximal to the brachiocephalic artery), regardless of origin
Can extend proximally to the aortic valve and distally to the descending aorta
Generally requires surgery
Complications include aortic regurgitation and cardiac tamponade.
Stanford type B aortic dissection: any dissection not involving the ascending aorta
Descending aorta; originating distal to the left subclavian artery
Most cases can be managed with medical therapy (e.g., beta blockers, vasodilators).
Stanford A = Affects ascending aorta; Stanford B = Begins beyond brachiocephalic vessels
Describe the DeBakey classification (rarely used).
Type I
Dissections originate in the ascending aorta and continue to at least the aortic arch but typically as far as the descending aorta.
Type II
Dissections originate in, and are restricted to, the ascending aorta.
Type III
Dissections originate in the descending aorta and most often extend distally.
Most cases can be managed by medical therapy.
Can be further subdivided into:
Type IIIa: limited to the descending thoracic aorta above the level of the diaphragm
Type IIIb: extends below the diaphragm
Classification (figure).
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