4.8 Article

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

Journal

CIRCULATION
Volume 146, Issue 24, Pages E334-E482

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1161/CIR.0000000000001106

Keywords

AHA Scientific Statements; abdominal aortic aneurysm; aortic dissection; aortitis; aortopathy; bicuspid aortic valve; blunt traumatic aortic injury; cardiac surgery; guidelines; endovascular aortic repair; heritable thoracic aortic disease; intramural hematoma; malperfusion syndrome; Marfan syndrome; Loeys-Dietz syndrome; penetrating atherosclerotic ulcer; thoracic aortic aneurysm; thoracoabdominal aortic aneurysm; thoracic endovascular aortic repair; vascular surgery

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The 2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease provides recommendations for clinicians on the diagnosis, genetic evaluation, medical therapy, endovascular and surgical treatment, and long-term surveillance of patients with various clinical presentations of aortic disease. The guideline emphasizes the importance of shared decision making and institutional interventional volume and multidisciplinary expertise in the care of patients with aortic disease.
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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