Hey team! I hope you and your loved ones are having a fabulous week. Thanks for joining us today for another Topic Tuesday, where we share some information about the aorta and body.
Some of you may have seen that recently, European and American experts have come together to draft a new set of guidelines for the diagnosis and treatment of diseases of the aorta. These guidelines represent a historic day as for the first time, the aorta was considered to be an independent organ.
Why is this important?
In the words of the authors themselves, the medical and scientific community have come to realize that the aortic organ serves a unique and integral function that make it stand out from the heart and other blood vessels in the body. In recognizing this importance, it is important for doctors to have an updated understanding of the aorta's anatomy, function and the different diseases and conditions that may effect it.
With this viewpoint, the authors go on to discuss various components of aortic management in the document, including imaging, how to define disease throughout the aorta and appropriate thresholds for intervention.
One highlight from the document was the experts' class I recommendation to standardize the reporting of extent of aortic disease by using "Ishimaru zones." This will allow doctors to precisely describe how far along the aorta an aneurysm or dissection extends by using pre-defined zones relative to the location and branches coming off the aorta:
Some other highlights from the new guidelines include the following:
In patients with complicated acute type B aortic dissection and amenable anatomy, TEVAR is recommended.
In patients presenting with acute Type A aortic dissection, emergency surgery with exclusion or resection of the primary entry tear in the ascending aorta and arch is recommended.
Genetic testing is recommended in patients <60 years old with thoracic aortic disease , family history of thoracic aortic disease, arterial aneurysms in other segments and those with syndromes that predispose them to aortic disease.
Aortic repair is recommended for asymptomatic thoracoabdominal aneurysms ≥55 mm
Surgery can be considered for ascending aortic aneurysms irrespective of size if they are producing symptoms and non-aortic causes of those symptoms have been ruled out.
The full guidelines can be read at - https://www.annalsthoracicsurgery.org/article/S0003-4975(24)00077-8/fulltext
And that's it for this week! Thank you for joining us and I hope you come back next week for another session led by Duc. Thank you all so much and remember to always #ThinkAorta!
Adham