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Thoracic aortic dissection

MedGen UID:
196449
•Concept ID:
C0729233
•
Disease or Syndrome
Synonyms: Aorta Dissection, Thoracic; Aortic Dissection, Thoracic; Dissection, Thoracic Aorta; Dissection, Thoracic Aortic; Thoracic Aorta Dissection; Thoracic Aorta Dissections; Thoracic Aortic Dissection; Thoracic Aortic Dissections
SNOMED CT: Dissection of thoracic aorta (233994002)

Definition

Dissection or a tear of the THORACIC AORTA. It includes aortic root dissection, ascending aortic dissection, aortic arch dissection and descending thoracic aortic dissection. [from MeSH]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • Thoracic aortic dissection

Professional guidelines

PubMed

Management of Descending Thoracic Aortic Diseases: Similarities and Differences Among Cardiovascular Guidelines.
Spanos K, Nana P, Behrendt CA, Kouvelos G, Panuccio G, Heidemann F, Matsagkas M, Debus ES, Giannoukas A, Kölbel T
J Endovasc Ther 2021 Apr;28(2):323-331. Epub 2021 Jan 13 doi: 10.1177/1526602820987808. PMID: 33435805
Guidelines for the management of thoracic aortic disease in 2017.
Mokashi SA, Svensson LG
Gen Thorac Cardiovasc Surg 2019 Jan;67(1):59-65. Epub 2017 Oct 13 doi: 10.1007/s11748-017-0831-8. PMID: 29030719
Descending thoracic aortic dissection: evaluation and management in the era of endovascular technology.
Lin PH, Huynh TT, Kougias P, Huh J, LeMaire SA, Coselli JS
Vasc Endovascular Surg 2009 Feb-Mar;43(1):5-24. Epub 2008 Jun 25 doi: 10.1177/1538574408318475. PMID: 18583304

Recent clinical studies

Etiology

Management of Thoracic Aortic Dissection.
Hameed I, Cifu AS, Vallabhajosyula P
JAMA 2023 Mar 7;329(9):756-757. doi: 10.1001/jama.2023.0265. PMID: 36795378
Acute aortic dissection: evidence, uncertainties, and future therapies.
Rylski B, Schilling O, Czerny M
Eur Heart J 2023 Mar 7;44(10):813-821. doi: 10.1093/eurheartj/ehac757. PMID: 36540036
Risk Factors for Thoracic Aortic Dissection.
Zhou Z, Cecchi AC, Prakash SK, Milewicz DM
Genes (Basel) 2022 Oct 7;13(10) doi: 10.3390/genes13101814. PMID: 36292699Free PMC Article
Thoracic Aortic Aneurysm: A Clinical Review.
Senser EM, Misra S, Henkin S
Cardiol Clin 2021 Nov;39(4):505-515. doi: 10.1016/j.ccl.2021.06.003. PMID: 34686263
Acute Chest Pain in Adults: Outpatient Evaluation.
McConaghy JR, Sharma M, Patel H
Am Fam Physician 2020 Dec 15;102(12):721-727. PMID: 33320506

Diagnosis

Management of Thoracic Aortic Dissection.
Hameed I, Cifu AS, Vallabhajosyula P
JAMA 2023 Mar 7;329(9):756-757. doi: 10.1001/jama.2023.0265. PMID: 36795378
Acute aortic dissection: evidence, uncertainties, and future therapies.
Rylski B, Schilling O, Czerny M
Eur Heart J 2023 Mar 7;44(10):813-821. doi: 10.1093/eurheartj/ehac757. PMID: 36540036
Thoracic Aortic Aneurysm: A Clinical Review.
Senser EM, Misra S, Henkin S
Cardiol Clin 2021 Nov;39(4):505-515. doi: 10.1016/j.ccl.2021.06.003. PMID: 34686263
Acute Chest Pain in Adults: Outpatient Evaluation.
McConaghy JR, Sharma M, Patel H
Am Fam Physician 2020 Dec 15;102(12):721-727. PMID: 33320506
Thoracic aortic aneurysm and dissection.
Goldfinger JZ, Halperin JL, Marin ML, Stewart AS, Eagle KA, Fuster V
J Am Coll Cardiol 2014 Oct 21;64(16):1725-39. doi: 10.1016/j.jacc.2014.08.025. PMID: 25323262

Therapy

Causal Role for Neutrophil Elastase in Thoracic Aortic Dissection in Mice.
Yang M, Zhou X, Pearce SWA, Yang Z, Chen Q, Niu K, Liu C, Luo J, Li D, Shao Y, Zhang C, Chen D, Wu Q, Cutillas PR, Zhao L, Xiao Q, Zhang L
Arterioscler Thromb Vasc Biol 2023 Oct;43(10):1900-1920. Epub 2023 Aug 17 doi: 10.1161/ATVBAHA.123.319281. PMID: 37589142Free PMC Article
ANGPTL8 deletion attenuates abdominal aortic aneurysm formation in ApoE-/- mice.
Yu H, Jiao X, Yang Y, Lv Q, Du Z, Li L, Hu C, Du Y, Zhang J, Li F, Sun Q, Wang Y, Chen D, Zhang X, Qin Y
Clin Sci (Lond) 2023 Jun 28;137(12):979-993. doi: 10.1042/CS20230031. PMID: 37294581Free PMC Article
Male-female differences in acute thoracic aortic dissection: a systematic review and meta-analysis.
Meccanici F, Gökalp AL, Thijssen CGE, Mokhles MM, Bekkers JA, van Kimmenade R, Verhagen HJ, Roos-Hesselink JW, Takkenberg JJM
Interact Cardiovasc Thorac Surg 2022 Mar 31;34(4):616-627. doi: 10.1093/icvts/ivab270. PMID: 34664071Free PMC Article
Aortic progression and reintervention in patients with pathogenic variants after a thoracic aortic dissection.
Norton EL, Hornsby WE, Wu X, Wolford BN, Graham SE, Willer CJ, Yang B
J Thorac Cardiovasc Surg 2021 Nov;162(5):1436-1448.e6. Epub 2020 Feb 20 doi: 10.1016/j.jtcvs.2020.01.094. PMID: 32199657Free PMC Article
Thoracic aortic dissection: long-term results of endovascular and open repair.
Subramanian S, Roselli EE
Semin Vasc Surg 2009 Jun;22(2):61-8. doi: 10.1053/j.semvascsurg.2009.04.006. PMID: 19573743

Prognosis

Risk prediction for thoracic aortic dissection: Is it time to go with the flow?
Salmasi MY, Pirola S, Asimakopoulos G, Nienaber C, Athanasiou T; London Aortic Mechanobiology Working Group
J Thorac Cardiovasc Surg 2023 Oct;166(4):1034-1042. Epub 2022 May 16 doi: 10.1016/j.jtcvs.2022.05.016. PMID: 35672182
Thoracic Aortic Aneurysm: A Clinical Review.
Senser EM, Misra S, Henkin S
Cardiol Clin 2021 Nov;39(4):505-515. doi: 10.1016/j.ccl.2021.06.003. PMID: 34686263
Acute Chest Pain in Adults: Outpatient Evaluation.
McConaghy JR, Sharma M, Patel H
Am Fam Physician 2020 Dec 15;102(12):721-727. PMID: 33320506
Predictive imaging for thoracic aortic dissection and rupture: moving beyond diameters.
Adriaans BP, Wildberger JE, Westenberg JJM, Lamb HJ, Schalla S
Eur Radiol 2019 Dec;29(12):6396-6404. Epub 2019 Jul 5 doi: 10.1007/s00330-019-06320-7. PMID: 31278573Free PMC Article
Image Predictors of Treatment Outcome after Thoracic Aortic Dissection Repair.
Saremi F, Hassani C, Lin LM, Lee C, Wilcox AG, Fleischman F, Cunningham MJ
Radiographics 2018 Nov-Dec;38(7):1949-1972. Epub 2018 Oct 12 doi: 10.1148/rg.2018180025. PMID: 30312138

Clinical prediction guides

Causal Role for Neutrophil Elastase in Thoracic Aortic Dissection in Mice.
Yang M, Zhou X, Pearce SWA, Yang Z, Chen Q, Niu K, Liu C, Luo J, Li D, Shao Y, Zhang C, Chen D, Wu Q, Cutillas PR, Zhao L, Xiao Q, Zhang L
Arterioscler Thromb Vasc Biol 2023 Oct;43(10):1900-1920. Epub 2023 Aug 17 doi: 10.1161/ATVBAHA.123.319281. PMID: 37589142Free PMC Article
Methods and Outcomes of Endovascular False Lumen Embolization for Thoracic Aortic Dissection.
Li HL, Chan YC, Jia HY, Cheng SW
Ann Vasc Surg 2022 Sep;85:371-382. Epub 2022 Mar 24 doi: 10.1016/j.avsg.2022.03.020. PMID: 35339592
Thoracic Aortic Aneurysm: A Clinical Review.
Senser EM, Misra S, Henkin S
Cardiol Clin 2021 Nov;39(4):505-515. doi: 10.1016/j.ccl.2021.06.003. PMID: 34686263
Acute Chest Pain in Adults: Outpatient Evaluation.
McConaghy JR, Sharma M, Patel H
Am Fam Physician 2020 Dec 15;102(12):721-727. PMID: 33320506
Predictive imaging for thoracic aortic dissection and rupture: moving beyond diameters.
Adriaans BP, Wildberger JE, Westenberg JJM, Lamb HJ, Schalla S
Eur Radiol 2019 Dec;29(12):6396-6404. Epub 2019 Jul 5 doi: 10.1007/s00330-019-06320-7. PMID: 31278573Free PMC Article

Recent systematic reviews

Comparison of Chimney and Fenestrated Techniques for Supra-Aortic Branch Revascularization During Thoracic Endovascular Aortic Repair: A Systematic Review and Meta-Analysis.
Liu M, Wu X, Wu S, Li X, Xin S, Zhang J
Cardiovasc Intervent Radiol 2023 Oct;46(10):1315-1328. Epub 2023 Sep 8 doi: 10.1007/s00270-023-03537-4. PMID: 37684487
Is There Enough Evidence to Support the Role of Glycosaminoglycans and Proteoglycans in Thoracic Aortic Aneurysm and Dissection?-A Systematic Review.
Rai P, Robinson L, Davies HA, Akhtar R, Field M, Madine J
Int J Mol Sci 2022 Aug 16;23(16) doi: 10.3390/ijms23169200. PMID: 36012466Free PMC Article
Methods and Outcomes of Endovascular False Lumen Embolization for Thoracic Aortic Dissection.
Li HL, Chan YC, Jia HY, Cheng SW
Ann Vasc Surg 2022 Sep;85:371-382. Epub 2022 Mar 24 doi: 10.1016/j.avsg.2022.03.020. PMID: 35339592
Male-female differences in acute thoracic aortic dissection: a systematic review and meta-analysis.
Meccanici F, Gökalp AL, Thijssen CGE, Mokhles MM, Bekkers JA, van Kimmenade R, Verhagen HJ, Roos-Hesselink JW, Takkenberg JJM
Interact Cardiovasc Thorac Surg 2022 Mar 31;34(4):616-627. doi: 10.1093/icvts/ivab270. PMID: 34664071Free PMC Article
Echocardiographic aortic root dilatation in hypertensive patients: a systematic review and meta-analysis.
Covella M, Milan A, Totaro S, Cuspidi C, Re A, Rabbia F, Veglio F
J Hypertens 2014 Oct;32(10):1928-35; discussion 1935. doi: 10.1097/HJH.0000000000000286. PMID: 24979304

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