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.

目标：我们描述了一种新的主​​动脉弓夹层 (AcD) 分类，我们称之为 Fuwai 分类。然后我们比较了不同分类的临床特征和长期预后。

方法：2010 年至 2015 年在阜外医院接受外科手术的所有 AcD 患者均纳入研究。AcD 程序分为三种类型：Fuwai 型 Cp、Ct 和 Cd。Cp 型定义为无名动脉或与受累的左颈动脉相结合。Cd 型定义为左锁骨下动脉或合并受累的左颈动脉。所有其他 AcD 手术都定义为 Ct 型。三种类型之间的两两比较采用卡方检验。Kaplan-Meier用于长期生存和免再手术生存分析。

结果：从 2010 年到 2015 年，总共招募了 1,063 名 AcD 患者：54 名患者为 Cp 型，832 名患者为 Ct 型，177 名患者为 Cd 型。Cp、Ct、Cd手术比例最高的是部分牙弓置换、全牙弓置换和TEVAR。与 Cd 型相比，Ct 型的手术死亡率更高（Ct 与 Cd = 9.38 与 1.69%，磷 < 0.01) 和 Cp 类型（Ct vs. Cp = 9.38 vs. 1.85%， 磷= 0.06）。Cp 型和 Cd 型手术死亡率没有差异（磷= 0.93）。长期生存率无显着差异（磷 = 0.38) 并且没有与主动脉相关的再手术 (磷 = 0.19）。

结论：Fuwai 分类用于区分不同的 AcD。不同的 AcD 具有不同的手术死亡率和使用不同的手术方法，但它们具有相似的长期结果。