CONGRESS ABSTRACT

Objective. Early blood pressure behaviour after acute aortic dissection differs from type A and type B dissections and this may reflect either intrinsic disease differences or the effect of divergent management pathways. This study compared early blood pressure behaviour during the first post-dissection period (up to 15 days after dissection) and evaluated the clinical and anatomical factors shaping instability in these two settings. Methods. We retrospectively analysed 86 patients (45 residual type A, 41 type B) using window-specific hypertension burden, extreme hypertensive events, and qualitative BP control classes. Additional variables included number of antihypertensive drugs, duration of intravenous antihypertensive therapy, renal artery dissection, renal malperfusion, and residual supra-aortic trunk (SAT) dissection. Early adverse events—rupture and 30-day mortality—were recorded. Results. Type B patients showed pronounced early instability with rapid improvement after 72 hours, whereas residual type A patients demonstrated persistent but lower-amplitude postoperative instability. Very-early and 30-day mortality were low (3 deaths), and early TEVAR occurred in 6 patients, equally distributed. Yet, no early, late, or completion-related survival differences emerged, and multivariable analyses did not identify independent predictors. Conclusions. The differences between type B and residual type A dissection do not necessarily represent two distinct diseases but rather two clinical phenotypes shaped by anatomy, residual aortic architecture, and management strategy. BP behaviour appears to reflect these contextual factors more than the A/B morphological classification itself. Integrating anatomical features, treatment intensity, and continuous BP metrics yields a realistic early-risk profile that may inform individualized hemodynamic management across both groups.