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Knowledge gaps in surgical management for aortic dissection.

Publication ,  Journal Article
Tanaka, A; Hebert, AM; Smith-Washington, A; Hoffstaetter, T; Goldenberg, R; Vemulapalli, S; Del Río-Solá, L; Arnaoutakis, GJ; Mussa, F; Ota, T ...
Published in: Semin Vasc Surg
March 2022

Aortic dissection (AD) is recognized as a potentially fatal condition and its standard treatment has been surgical intervention for acute type A AD (TAAD) and complicated acute type B AD (TBAD), and medical management for uncomplicated acute type B AD. Due to rapidly evolving device technologies and minimally invasive surgical techniques that have lowered perioperative risk, there are paradigm shifts for the indications and treatment options for both TAAD and TBAD. In this article, we will discuss the current indications and treatment options for TAAD and TBAD by chronicity of the disease, which comprises four categories: acute TAAD, chronic (repaired) TAAD, acute TBAD, and chronic TBAD. We will also discuss the knowledge gaps in the current surgical management strategies and literature evidence. Open surgical intervention remains the reference standard for acute TAAD and chronic TAAD with complications until an endoprosthesis that will suit the complex anatomy of aortic root, ascending aorta, and aortic arch is developed. Thoracic endovascular aortic repair is now the first line for complicated acute and chronic TBADs. However, we need a larger trials to support the safety and durability of the procedures in patients with uncomplicated TBAD. Without additional data, patients are left to choose between existing treatment options, such as open surgical repair and stent-grafting.

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Published In

Semin Vasc Surg

DOI

EISSN

1558-4518

Publication Date

March 2022

Volume

35

Issue

1

Start / End Page

35 / 42

Location

United States

Related Subject Headings

  • Stents
  • Humans
  • Endovascular Procedures
  • Cardiovascular System & Hematology
  • Aortic Dissection
  • Aorta, Thoracic
  • Aorta
  • 1103 Clinical Sciences
  • 1102 Cardiorespiratory Medicine and Haematology
 

Citation

APA
Chicago
ICMJE
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Tanaka, A., Hebert, A. M., Smith-Washington, A., Hoffstaetter, T., Goldenberg, R., Vemulapalli, S., … Aortic Dissection Collaborative, . (2022). Knowledge gaps in surgical management for aortic dissection. Semin Vasc Surg, 35(1), 35–42. https://doi.org/10.1053/j.semvascsurg.2022.02.009
Tanaka, Akiko, Avery M. Hebert, Akili Smith-Washington, Tabea Hoffstaetter, Richard Goldenberg, Sreekanth Vemulapalli, Lourdes Del Río-Solá, et al. “Knowledge gaps in surgical management for aortic dissection.Semin Vasc Surg 35, no. 1 (March 2022): 35–42. https://doi.org/10.1053/j.semvascsurg.2022.02.009.
Tanaka A, Hebert AM, Smith-Washington A, Hoffstaetter T, Goldenberg R, Vemulapalli S, et al. Knowledge gaps in surgical management for aortic dissection. Semin Vasc Surg. 2022 Mar;35(1):35–42.
Tanaka, Akiko, et al. “Knowledge gaps in surgical management for aortic dissection.Semin Vasc Surg, vol. 35, no. 1, Mar. 2022, pp. 35–42. Pubmed, doi:10.1053/j.semvascsurg.2022.02.009.
Tanaka A, Hebert AM, Smith-Washington A, Hoffstaetter T, Goldenberg R, Vemulapalli S, Del Río-Solá L, Arnaoutakis GJ, Mussa F, Ota T, Aortic Dissection Collaborative. Knowledge gaps in surgical management for aortic dissection. Semin Vasc Surg. 2022 Mar;35(1):35–42.
Journal cover image

Published In

Semin Vasc Surg

DOI

EISSN

1558-4518

Publication Date

March 2022

Volume

35

Issue

1

Start / End Page

35 / 42

Location

United States

Related Subject Headings

  • Stents
  • Humans
  • Endovascular Procedures
  • Cardiovascular System & Hematology
  • Aortic Dissection
  • Aorta, Thoracic
  • Aorta
  • 1103 Clinical Sciences
  • 1102 Cardiorespiratory Medicine and Haematology