Details

Autor(en) / Beteiligte

• Hiratzka, Loren F., MD
• Bakris, George L., MD
• Beckman, Joshua A., MD, MS
• Bersin, Robert M., MD
• Carr, Vincent F., DO
• Casey, Donald E., MD, MPH, MBA
• Eagle, Kim A., MD
• Hermann, Luke K., MD
• Isselbacher, Eric M., MD
• Kazerooni, Ella A., MD, MS
• Kouchoukos, Nicholas T., MD
• Lytle, Bruce W., MD
• Milewicz, Dianna M., MD, PhD
• Reich, David L., MD
• Sen, Souvik, MD, MS
• Shinn, Julie A., RN, MA, CCRN
• Svensson, Lars G., MD, PhD
• Williams, David M., MD

Titel

2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease

Ist Teil von

• Journal of the American College of Cardiology, 2010-04, Vol.55 (14), p.e27-e129

Ort / Verlag

New York: Elsevier Inc

Erscheinungsjahr

2010

Quelle

EZB Electronic Journals Library

Beschreibungen/Notizen

• ACCF/AHA Task Force Members Alice K. Jacobs, MD, FACC, FAHA, Chair 2009-2011; Sidney C. Smith, Jr, MD, FACC, FAHA, Immediate Past Chair 2006-2008[dagger][dagger][dagger]; Jeffery L. Anderson, MD, FACC, FAHA, Chair-Elect; Cynthia D. Adams, MSN, PhD, FAHA[dagger][dagger][dagger]; Christopher E. Buller, MD, FACC; Mark A. Creager, MD, FACC, FAHA; Steven M. Ettinger, MD, FACC; Robert A. Guyton, MD, FACC, FAHA; Jonathan L. Halperin, MD, FACC, FAHA; Sharon A. Hunt, MD, FACC, FAHA[dagger][dagger][dagger]; Harlan M. Krumholz, MD, FACC, FAHA[dagger][dagger][dagger]; Frederick G. Kushner, MD, FACC, FAHA; Bruce W. Lytle, MD, FACC, FAHA[dagger][dagger][dagger]; Rick Nishimura, MD, FACC, FAHA[dagger][dagger][dagger]; Richard L. Page, MD, FACC, FAHA[dagger][dagger][dagger]; Barbara Riegel, DNSc, RN, FAHA***; William G. Stevenson, MD, FACC, FAHA; Lynn G. Tarkington, RN; Clyde W. Yancy, MD, FACC, FAHA Table of Contents Preamble...e31 Introduction...e31 Methodology and Evidence Review...e31 Organization of the Writing Committee...e32 Document Review and Approval...e32 Scope of the Guideline...e33 Critical Issues...e35 Glossary of Terms and Abbreviations Used Throughout Guideline...e35 The Thoracic Aorta...e36 The Normal Aorta...e36 Normal Thoracic Aortic Diameter...e36 Thoracic Aortic Histopathology...e37 Atherosclerosis...e37 Aneurysms and Dissections...e37 Vasculitis and Inflammatory Diseases...e38 Imaging Modalities...e39 Recommendations for Aortic Imaging Techniques to Determine the Presence and Progression of Thoracic Aortic Disease...e39 Chest X-Ray...e40 Computed Tomographic Imaging...e40 Computed Tomographic Imaging Technique...e42 Magnetic Resonance Imaging...e42 Magnetic Resonance Imaging Technique ...e43 Black Blood Imaging...e43 Noncontrast White Blood Imaging...e43 Contrast-Enhanced Magnetic Resonance Angiography...e43 Phase Contrast Imaging...e43 Standards for Reporting of the Thoracic Aorta on Computed Tomography and Magnetic Resonance Imaging...e43 Angiography...e44 Echocardiography...e45 Echocardiographic Criteria for Thoracic Aortic Aneurysms...e45 Echocardiographic Criteria for Aortic Dissection...e45 Diagnostic Accuracy of Echocardiography for Aortic Dissection...e46 Diagnostic Accuracy of Echocardiography for Acute Intramural Hematoma...e46 Role of Echocardiography in Following Patients With Chronic Aortic Disease...e47 Genetic Syndromes Associated With Thoracic Aortic Aneurysms and Dissections...e47 Recommendations for Genetic Syndromes...e47 Marfan Syndrome...e48 Loeys-Dietz Syndrome...e49 Ehlers-Danlos Syndrome, Vascular Form or Type IV...e49 Turner Syndrome...e49 Other Genetic Syndromes With Increased Risk for Thoracic Aortic Aneurysms and Dissections...e50 Recommendations for Familial Thoracic Aortic Aneurysms and Dissections...e50 Summary...e51 Other Cardiovascular Conditions Associated With Thoracic Aortic Aneurysm and Dissection...e52 Recommendations for Bicuspid Aortic Valve and Associated Congenital Variants in Adults...e52 Aberrant Right Subclavian Artery...e53 Coarctation of the Aorta...e53 Right Aortic Arch...e53 Inflammatory Diseases Associated With Thoracic Aortic Disease...e53 Recommendations for Takayasu Arteritis and Giant Cell Arteritis...e53 Takayasu Arteritis...e54 Giant Cell Arteritis...e56 Behçet Disease...e57 Ankylosing Spondylitis (Spondyloarthropathies) ...e57 Infective Thoracic Aortic Aneurysms...e57 Acute Aortic Syndromes...e58 Aortic Dissection...e58 Aortic Dissection Definition...e58 Anatomic Classification of Aortic Dissection...e58 Risk Factors for Aortic Dissection...e61 Clinical Presentation of Acute Thoracic Aortic Dissection...e62 Symptoms of Acute Thoracic Aortic Dissection...e62 Perfusion Deficits and End-Organ Ischemia...e62 Cardiac Complications...e64 Acute Aortic Regurgitation...e64 Myocardial Ischemia or Infarction...e64 Heart Failure and Shock...e64 Pericardial Effusion and Tamponade...e64 Syncope...e64 Neurologic Complications...e65 Pulmonary Complications...e65 Gastrointestinal Complications...e65 Blood Pressure and Heart Rate Considerations...e65 Age and Sex Considerations...e65 Intramural Hematoma...e66 Penetrating Atherosclerotic Ulcer...e67 Pseudoaneurysms of the Thoracic Aorta...e67 Traumatic Rupture of the Thoracic Aorta...e67 Evaluation and Management of Acute Thoracic Aortic Disease...e68 Initial Evaluation and Management...e68 Recommendations for Estimation of Pretest Risk of Thoracic Aortic Dissection...e68 Laboratory Testing...e68 Recommendations for Screening Tests...e69 Recommendations for Diagnostic Imaging Studies...e69 Recommendations for Initial Management...e69 Recommendations for Definitive Management...e69 Evaluation and Management Algorithms...e70 Initial Management...e71 Blood Pressure and Rate Control Therapy...e71 Additional Antihypertensive Therapy...e73 Pain Control...e73 Hypotension...e73 Determining Definitive Management...e73 Recommendation for Surgical Intervention for Acute Thoracic Aortic Dissection...e73 Endovascular Interventions...e73 Principles of Treatment for Intramural Hematoma and Penetrating Atherosclerotic Ulcer...e74 Intimal Defect Without Intramural Hematoma...e74 Intimal Defect With Intramural Hematoma...e74 Recommendation for Intramural Hematoma Without Intimal Defect...e74 Treatment for the Management of Traumatic Aortic Rupture...e74 Thoracic Aortic Aneurysms...e75 General Approach to the Patient...e76 Recommendation for History and Physical Examination for Thoracic Aortic Disease...e76 Coronary Artery Disease...e77 Emboli...e78 Associated Renal Ischemia...e78 Associated Mesenteric Ischemia...e78 Associated Peripheral Ischemia...e78 Differential Diagnosis...e78 Symptoms...e78 Physical Findings...e78 Considerations for Imaging...e79 General Medical Treatment and Risk Factor Management for Patients With Thoracic Aortic Disease...e79 Recommendation for Medical Treatment of Patients With Thoracic Aortic Diseases...e79 Recommendations for Blood Pressure Control...e80 Recommendation for Dyslipidemia...e80 Recommendation for Smoking Cessation...e80 Surgical and Endovascular Treatment by Location of Disease...e81 Ascending Aorta and Aortic Sinuses...e81 Recommendations for Asymptomatic Patients With Ascending Aortic Aneurysm...e81 Recommendation for Symptomatic Patients With Thoracic Aortic Aneurysm...e81 Endovascular Grafting for Ascending Aortic Aneurysm...e82 Recommendations for Open Surgery for Ascending Aortic Aneurysm...e82 Recommendations for Aortic Arch Aneurysms...e84 Open Surgery...e84 Descending Thoracic Aorta and Thoracoabdominal Aorta...e84 Recommendations for Descending Thoracic Aorta and Thoracoabdominal Aortic Aneurysms...e84 Endovascular Versus Open Surgical Approach...e85 End-Organ Preservation During Thoracic Endograft Implantation...e86 Periprocedural Complications of Endograft Procedures...e87 Open Surgical...e88 End-Organ Preservation During Open Thoracoabdominal Repairs...e89 Aortic Dissection With Malperfusion...e89 Special Considerations in Pregnant Patients With Aortic Disease...e89 Effects of Pregnancy on the Aorta...e89 Epidemiology of Chronic and Acute Aortic Conditions in Pregnancy...e89 Counseling and Management of Chronic Aortic Diseases in Pregnancy...e90 Recommendations for Counseling and Management of Chronic Aortic Diseases in Pregnancy...e89 Evaluation and Management of Acute Aortic Syndromes During Pregnancy...e90 Aortic Arch and Thoracic Aortic Atheroma and Atheroembolic Disease...e90 Recommendations for Aortic Arch and Thoracic Aortic Atheroma and Atheroembolic Disease...e90 Clinical Description...e90 Risk Factors...e91 Diagnosis...e91 Treatment...e91 Anticoagulation Versus Antiplatelet Therapy...e91 Lipid-Lowering Agent...e92 Surgical and Interventional Approaches...e92 Porcelain Aorta...e92 Tumors of the Thoracic Aorta...e93 Perioperative Care for Open Surgical and Endovascular Thoracic Aortic Repairs...e93 Recommendations for Preoperative Evaluation...e93 Preoperative Risk Assessment...e94 Recommendations for Choice of Anesthetic and Monitoring Techniques...e95 Temperature Monitoring...e95 Hemodynamic Monitoring...e95 Transesophageal Echocardiography...e96 Transesophageal Echocardiography for Endovascular Repairs of the Descending Thoracic Aorta...e96 Airway Management for Descending Thoracic Aortic Repairs...e96 Recommendation for Transfusion Management and Anticoagulation in Thoracic Aortic Surgery...e96 Organ Protection...e97 Recommendations for Brain Protection During Ascending Aortic and Transverse Aortic Arch Surgery...e97 Recommendations for Spinal Cord Protection During Descending Aortic Open Surgical and Endovascular Repairs...e98 Monitoring of Spinal Cord Function in Descending Thoracic Aortic Repairs...e99 Maintenance of Spinal Cord Arterial Pressure...e99 Cerebrospinal Fluid Pressure and Drainage...e99 Hypothermia...e100 Glucocorticoids and Mannitol...e100 Recommendations for Renal Protection During Descending Aortic Open Surgical and Endovascular Repairs...e100 Complications of Open Surgical Approaches...e100 Mortality Risk for Thoracic Aortic Surgery...e101 Postprocedural Care...e102 Postoperative Risk Factor Management...e102 Recommendations for Surveillance of Thoracic Aortic Disease or Previously Repaired Patients...e102 Nursing Care and Patient/Family Education...e103 Nursing Care of Medically Managed Patients...