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Acute Aortic Syndromes: Diagnostic and Therapeutic Pathways

Eduardo Bossone1, Brigida Ranieri2, Luigia Romano3

  • 1Cardiology Division, Antonio Cardarelli Hospital, Via A. Cardarelli 9, Naples I-80131, Italy.

Heart Failure Clinics
|June 7, 2020
PubMed

Insights

Acute aortic syndromes, including acute aortic dissection (AAD), are serious conditions requiring prompt diagnosis and management. Treatment varies by type, with surgery for Type A and medical or endovascular approaches for Type B AAD.

Area of Science:

  • Cardiology
  • Vascular Surgery
  • Emergency Medicine

Background:

  • Acute aortic syndromes (AAS) encompass life-threatening conditions like acute aortic dissection (AAD).
  • These conditions necessitate precise and timely diagnostic and therapeutic strategies.
  • The European Society of Cardiology provides a diagnostic algorithm for AAS.

Purpose of the Study:

  • To outline the diagnostic and management strategies for acute aortic syndromes.
  • To differentiate treatment pathways based on AAD classification (Type A vs. Type B).
  • To emphasize the chronic nature of AAD, requiring lifelong management.

Main Methods:

  • Review of European Society of Cardiology guidelines for AAS diagnosis.
  • Description of a multiparametric diagnostic algorithm.
  • Outline of medical and surgical treatment modalities for AAD.

Main Results:

  • Aggressive medical therapy (blood pressure and heart rate control) is crucial for all AAD patients.
  • Urgent surgical repair is indicated for Type A AAD.
  • Uncomplicated Type B AAD is managed medically, while complicated Type B AAD benefits from thoracic endovascular repair.

Conclusions:

  • AAD is a lifelong condition affecting the entire aorta.
  • Management strategies are tailored to AAD type and complexity.
  • Multidisciplinary approaches are essential for optimal AAS patient outcomes.

Keywords:
Acute aortic syndromesAortic dissectionIntramural hematomaMultiparametric diagnostic algorithmPenetrating aortic ulcerSurgical repairThoracic endovascular aortic repair

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