Thread by @ACCinTouch

Check out the top 10🔑points from the🆕2022 ACC/@American_Heart Guideline for the Diagnosis & Management of #AorticDisease

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Because outcomes for patients w/ #aorticdisease are enhanced at programs w/ ⬆️ volumes, experienced practitioners & extensive management capabilities, Multidisciplinary Aortic Team care is considered in determining the appropriate⏰of intervention.

Shared Decision-Making (SDM) is encouraged to determine the optimal medical, endovascular & open surgical therapies. In pregnant patients w/ #aorticdisease SDM is🔑when considering CV risks of pregnancy, diameter thresholds for prophylactic aortic #cvSurg & mode of delivery.

CT, MRI & echocardiographic imaging of patients w/ #aorticdisease should follow recommended approaches for image acquisition, measurement & reporting of relevant aortic dimensions & frequency of surveillance before/after intervention.

At centers w/ Multidisciplinary Aortic Teams & experienced surgeons, the threshold for surgical intervention for sporadic aortic root & ascending aortic aneurysms has been ↘️ from 5.5 to 5.0 cm & ↘️ in scenarios among patients w/ heritable thoracic aortic aneurysms.

In patients significantly smaller or taller than avg, surgical thresholds may incorporate indexing of the aortic root or ascending aortic diameter to patient body surface area or height, or aortic cross-sectional area to patient height.

Rapid aortic root growth or ascending aortic aneurysm growth is defined as ≥0.5 cm in 1 year or ≥0.3 cm per year in 2 consecutive years for those w/ sporadic aneurysms & ≥0.3 cm in 1 year for those w/ heritable thoracic #aorticdisease or bicuspid aortic valve.

In patients undergoing aortic root replacement surgery, valve-sparing aortic root replacement is reasonable if the valve is suitable for repair & performed by experienced surgeons in a Multidisciplinary Aortic Team.

Patients w/ acute type A aortic dissection should be considered for transfer to a high-volume aortic center to improve survival. The operative repair of type A aortic dissection should entail at least an open distal anastomosis rather than a supracoronary interposition graft.

There is an ↗️ role for thoracic endovascular aortic repair in the mgmt of uncomplicated type B aortic dissection. Clinical trials of repair of thoracoabdominal aortic aneurysms w/ endografts are reporting results suggesting endovascular repair is an option for patients.

In patients w/ aneurysms of the aortic root, ascending aorta, or those w/ aortic dissection, screening of first-degree relatives with aortic imaging is recommended.

This #ClinicalGuideline provides guidance for clinicians on the diagnosis, genetic evaluation & family screening, medical therapy, endovascular & surgical treatment & long-term surveillance of patients w/ #aorticdisease. Read in full: jacc.org/doi/10.1016/j.…