Penn classification in acute aortic dissection patients

Objective The objective of this study was to evaluate the effectiveness of the Penn classification in predicting in-hospital mortality after surgeryin acute type A aortic dissection patients.Methods We evaluated 58 patients (42 men and 16 women; mean age 62.17 ± 10.6 years) who underwent emergency surgery for acute type Aaortic dissection between September 2003 and June 2010 in our department. We investigated the correlation between the pre-operative malperfusionand in-hospital outcome after surgery.Results Twenty-eight patients (48%) were Penn class Aa (absence of branch vessel malperfusion or circulatory collapse), 11 (19%) were Penn classAb (branch vessel malperfusion with ischaemia), 5 (9%) were Penn class Ac (circulatory collapse with or without cardiac involvement) and 14 (24%) werePenn class Abc (both branch vessel malperfusion and circulatory collapse). The number of patients with localized or generalized ischaemia or both, Pennclass non-Aa, was 30 (52%). In-hospital mortality was 24%. In-hospital mortality was significantly higher in Penn class Abc and Penn class non-Aa. Intensiveunit care stay, hospital ward stay and overall hospital stay was longer in Penn class non-Aa vs Penn class Aa. De Bakey type I dissection and type II diabetesmellitus were associated with in-hospital mortality.Conclusion Preoperative malperfusion is important for the evaluation of patients with acute aortic type A dissection. The Penn classification isa simple and quick method to apply and predict in-hospital mortality and outcomes.Keywords Type A dissection – Stanford classification – DeBakey classification – Penn classification.