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2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease: A Report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines
Open accessAbstract
AIM: The "2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease" provides recommendations to guide clinicians in the diagnosis, genetic evaluation and family screening, medical therapy, endovascular and surgical treatment, and long-term surveillance of patients with aortic disease across its multiple clinical presentation subsets (ie, asymptomatic, stable symptomatic, and acute aortic syndromes). METHODS: A comprehensive literature search was conducted from January 2021 to April 2021, encompassing studies, reviews, and other evidence conducted on human subjects that were published in English from PubMed, EMBASE, the Cochrane Library, CINHL Complete, and other selected databases relevant to this guideline. Additional relevant studies, published through June 2022 during the guideline writing process, were also considered by the writing committee, where appropriate. Structure: Recommendations from previously published AHA/ACC guidelines on thoracic aortic disease, peripheral artery disease, and bicuspid aortic valve disease have been updated with new evidence to guide clinicians. In addition, new recommendations addressing comprehensive care for patients with aortic disease have been developed. There is added emphasis on the role of shared decision making, especially in the management of patients with aortic disease both before and during pregnancy. The is also an increased emphasis on the importance of institutional interventional volume and multidisciplinary aortic team expertise in the care of patients with aortic disease.
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“Medical therapy of hypertension for individuals with TS and aortic dilation should preferably include a beta-blocker, angiotensin receptor blocker (ARB), or both, which have been shown to prevent aortic dilation and aortic dissections in individuals with other aortopathy conditions.439”
From Clinical practice guidelines for the care of girls and women with Turner syndrome. (2024) · cites this paper as [439]
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“In this context, applying the current absolute diameter thresholds for aortic dilation (>4.0 cm) or aneurysm (>4.5 cm) to adults with TS would almost certainly lead to delayed recognition of aortic disease.439”
From Clinical practice guidelines for the care of girls and women with Turner syndrome. (2024) · cites this paper as [439]
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Current approaches to spinal cord protection during open thoracoabdominal aortic aneurysm repair
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Differential aortic aneurysm formation provoked by chemogenetic oxidative stress
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2022 Aortic Disease Guideline-at-a-Glance
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Health-related quality of life in patients with aortic dissection: An unmet need
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“In patients with an aortic diameter of 56–59 mm, treatment may be considered [1,16,17].”
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Aortic aneurysm and dissection: complement and precision medicine in aortic disease
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“The 2022 guidelines also recommend consideration of repair at 5.5 cm or less in patients with high-risk features for rupture, including annual growth of the aneurysm by 0.5 cm or more, symptomatic aneurysms, significant change in the appearance of the aneurysm, saccular aneurysms, or aneurysms with penetrating atheros…”
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Coding and Non-Coding Transcriptomic Landscape of Aortic Complications in Marfan Syndrome
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“Aside from prophylactic surgery, medical treatment has been reported to slow the rate of aortic enlargement [1,14].”
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“Even incremental changes in diameter, such as those found in the control group in the present study (+1.13 mm over 2 years), are associated with increased aortic stiffness, left ventricular afterload, and an increased risk of subsequent heart failure, as well as in diabetic subjects [16,17].”
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“Numerous cannulation strategies for uni-and bilateral ACP (right axillary artery, common carotid arteries, innominate artery) have been implemented but there has been no clear consensus favoring one access route over the others [17].”
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Circulating Trimethylamine N-Oxide and Growth Rate of Abdominal Aortic Aneurysms and Surgical Risk
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Outcomes of Reoperative Aortic Root Replacement After Previous Acute Type A Dissection Repair
Pedroza, A. J., Dalal, A. R., Krishnan, A., Yokoyama, N., Nakamura, K., Tognozzi, E., Woo, Y.-P. J., MacArthur, J. W., & Fischbein, M. P. (2023) · Seminars in Thoracic and Cardiovascular Surgery · doi:10.1053/j.semtcvs.2023.02.001 · Cited by 11
Metadata
- Authors
- Isselbacher, E. M., Preventza, O., Hamilton Black, J., Augoustides, J. G., Beck, A. W., Bolen, M. A., Braverman, A. C., Bray, B. E., Brown-Zimmerman, M. M., Chen, E. P., Collins, T. J., DeAnda, A., Fanola, C. L., Girardi, L. N., Hicks, C. W., Hui, D. S., Schuyler Jones, W., Kalahasti, V., Kim, K. M., Milewicz, D. M., Oderich, G. S., Ogbechie, L., Promes, S. B., Gyang Ross, E., Schermerhorn, M. L., Singleton Times, S., Tseng, E. E., Wang, G. J., Woo, Y. J., Faxon, D. P., Upchurch, G. R., Aday, A. W., Azizzadeh, A., Boisen, M., Hawkins, B., Kramer, C. M., Luc, J. G. Y., MacGillivray, T. E., Malaisrie, S. C., Osteen, K., Patel, H. J., Patel, P. J., Popescu, W. M., Rodriguez, E., Sorber, R., Tsao, P. S., & Santos Volgman, A.
- Affiliations
- SCA representative.
- ACR representative.
- American Heart Association (US)
- Lay stakeholder representative.
- Fraunhofer Institute for Algorithms and Scientific Computing (DE)
- AATS representative.
- American Hospital Association (US)
- AHA/ACC Joint Committee on Clinical Practice Guidelines liaison.
- STS representative.
- SVS representative.
- AHA/ACC staff representative.
- ORCID
- Isselbacher, Eric M.
- Preventza, Ourania
- Augoustides, John G.
- Beck, Adam W.
- Bolen, Michael A.
- Braverman, Alan C.
- Bray, Bruce E.
- Chen, Edward P.
- DeAnda, Abe
- Fanola, Christina L.
- Girardi, Leonard N.
- Hicks, Caitlin W.
- Hui, Dawn S.
- Kalahasti, Vidyasagar
- Kim, Karen M.
- Milewicz, Dianna M.
- Oderich, Gustavo S.
- Promes, Susan B.
- Schermerhorn, Marc L.
- Tseng, Elaine E.
- Upchurch, Gilbert R.
- Aday, Aaron W.
- Azizzadeh, Ali
- Boisen, Michael
- Kramer, Christopher M.
- Luc, Jessica G.Y.
- MacGillivray, Thomas E.
- Osteen, Kathryn
- Patel, Himanshu J.
- Patel, Parag J.
- Popescu, Wanda M.
- Sorber, Rebecca
- Tsao, Philip S.
- Venue
- Circulation
- Published
- 2022-12-13
- Volume
- 146
- Issue
- 24
- Pages
- e334-e482
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- PMC
- PMC9876736
- OpenAlex
- W4307934708
- Cited by
- 2,082
- References
- 1,104
- Citations by year
- 2026: 600 · 2025: 569 · 2024: 554 · 2023: 348 · 2022: 9
- FWCI
- 239.09
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by
- Locations
- Circulation (publishedVersion, cc-by)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- U.S. Department of Veterans Affairs
- American Heart Association
- Massachusetts General Hospital
- American College of Cardiology Foundation
- University of Pennsylvania
- CryoLife
- Office of Science
- National Institute of Diabetes and Digestive and Kidney Diseases (K23DK124515)
- Division of Cardiothoracic Surgery, University of Colorado School of Medicine, Anschutz Medical Campus
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Aortic Disease and Treatment Approaches
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Connective tissue disorders research
- Health Sciences › Medicine › Surgery › Aortic aneurysm repair treatments
- Keywords
- aortic disease, thoracic aortic disease, acute aortic syndrome, aortic aneurysm, aortic dissection, bicuspid aortic valve disease, peripheral arterial disease, genetic evaluation, family screening, endovascular repair, aortic surgery, long-term surveillance, shared decision-making, pregnancy
- MeSH terms
- Bicuspid Aortic Valve Disease, American Heart Association, Aortic Diseases, Cardiology, Female, Humans, Pregnancy, United States, Research Report
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