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Thoracic aortic dissection

MedGen UID:
196449
•Concept ID:
C0729233
•
Disease or Syndrome
Synonyms: Aorta Dissection, Thoracic; Aortic Dissection, Thoracic; Dissection, Thoracic Aorta; Dissection, Thoracic Aortic; Thoracic Aorta Dissection; Thoracic Aorta Dissections; Thoracic Aortic Dissection; Thoracic Aortic Dissections
SNOMED CT: Dissection of thoracic aorta (233994002)

Definition

A tear within the wall of the thoracic aorta. [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • Thoracic aortic dissection

Professional guidelines

PubMed

HTAD patient pathway: Strategy for diagnostic work-up of patients and families with (suspected) heritable thoracic aortic diseases (HTAD). A statement from the HTAD working group of VASCERN.
Caruana M, Baars MJ, Bashiardes E, Benke K, Björck E, Codreanu A, de Moya Rubio E, Dumfarth J, Evangelista A, Groenink M, Kallenbach K, Kempers M, Keravnou A, Loeys B, Muiño-Mosquera L, Nagy E, Milleron O, Nistri S, Pepe G, Roos-Hesselink J, Szabolcs Z, Teixidó-Tura G, Timmermans J, Van de Laar I, van Kimmenade R, Verstraeten A, Von Kodolitsch Y, De Backer J, Jondeau G
Eur J Med Genet 2023 Jan;66(1):104673. Epub 2022 Nov 29 doi: 10.1016/j.ejmg.2022.104673. PMID: 36460281
Management of Descending Thoracic Aortic Diseases: Similarities and Differences Among Cardiovascular Guidelines.
Spanos K, Nana P, Behrendt CA, Kouvelos G, Panuccio G, Heidemann F, Matsagkas M, Debus ES, Giannoukas A, Kölbel T
J Endovasc Ther 2021 Apr;28(2):323-331. Epub 2021 Jan 13 doi: 10.1177/1526602820987808. PMID: 33435805
Guidelines for the management of thoracic aortic disease in 2017.
Mokashi SA, Svensson LG
Gen Thorac Cardiovasc Surg 2019 Jan;67(1):59-65. Epub 2017 Oct 13 doi: 10.1007/s11748-017-0831-8. PMID: 29030719

Recent clinical studies

Etiology

Management of Thoracic Aortic Dissection.
Hameed I, Cifu AS, Vallabhajosyula P
JAMA 2023 Mar 7;329(9):756-757. doi: 10.1001/jama.2023.0265. PMID: 36795378
Acute aortic dissection: evidence, uncertainties, and future therapies.
Rylski B, Schilling O, Czerny M
Eur Heart J 2023 Mar 7;44(10):813-821. doi: 10.1093/eurheartj/ehac757. PMID: 36540036
Risk Factors for Thoracic Aortic Dissection.
Zhou Z, Cecchi AC, Prakash SK, Milewicz DM
Genes (Basel) 2022 Oct 7;13(10) doi: 10.3390/genes13101814. PMID: 36292699Free PMC Article
Thoracic Aortic Aneurysm: A Clinical Review.
Senser EM, Misra S, Henkin S
Cardiol Clin 2021 Nov;39(4):505-515. doi: 10.1016/j.ccl.2021.06.003. PMID: 34686263
Acute Chest Pain in Adults: Outpatient Evaluation.
McConaghy JR, Sharma M, Patel H
Am Fam Physician 2020 Dec 15;102(12):721-727. PMID: 33320506

Diagnosis

Management of Thoracic Aortic Dissection.
Hameed I, Cifu AS, Vallabhajosyula P
JAMA 2023 Mar 7;329(9):756-757. doi: 10.1001/jama.2023.0265. PMID: 36795378
Acute aortic dissection: evidence, uncertainties, and future therapies.
Rylski B, Schilling O, Czerny M
Eur Heart J 2023 Mar 7;44(10):813-821. doi: 10.1093/eurheartj/ehac757. PMID: 36540036
HTAD patient pathway: Strategy for diagnostic work-up of patients and families with (suspected) heritable thoracic aortic diseases (HTAD). A statement from the HTAD working group of VASCERN.
Caruana M, Baars MJ, Bashiardes E, Benke K, Björck E, Codreanu A, de Moya Rubio E, Dumfarth J, Evangelista A, Groenink M, Kallenbach K, Kempers M, Keravnou A, Loeys B, Muiño-Mosquera L, Nagy E, Milleron O, Nistri S, Pepe G, Roos-Hesselink J, Szabolcs Z, Teixidó-Tura G, Timmermans J, Van de Laar I, van Kimmenade R, Verstraeten A, Von Kodolitsch Y, De Backer J, Jondeau G
Eur J Med Genet 2023 Jan;66(1):104673. Epub 2022 Nov 29 doi: 10.1016/j.ejmg.2022.104673. PMID: 36460281
Thoracic Aortic Aneurysm: A Clinical Review.
Senser EM, Misra S, Henkin S
Cardiol Clin 2021 Nov;39(4):505-515. doi: 10.1016/j.ccl.2021.06.003. PMID: 34686263
Acute Chest Pain in Adults: Outpatient Evaluation.
McConaghy JR, Sharma M, Patel H
Am Fam Physician 2020 Dec 15;102(12):721-727. PMID: 33320506

Therapy

Gut Microbiota-Derived Tryptophan Metabolite Indole-3-aldehyde Ameliorates Aortic Dissection.
Huang SS, Liu R, Chang S, Li X, Weng X, Ge J
Nutrients 2023 Sep 26;15(19) doi: 10.3390/nu15194150. PMID: 37836434Free PMC Article
Causal Role for Neutrophil Elastase in Thoracic Aortic Dissection in Mice.
Yang M, Zhou X, Pearce SWA, Yang Z, Chen Q, Niu K, Liu C, Luo J, Li D, Shao Y, Zhang C, Chen D, Wu Q, Cutillas PR, Zhao L, Xiao Q, Zhang L
Arterioscler Thromb Vasc Biol 2023 Oct;43(10):1900-1920. Epub 2023 Aug 17 doi: 10.1161/ATVBAHA.123.319281. PMID: 37589142Free PMC Article
ANGPTL8 deletion attenuates abdominal aortic aneurysm formation in ApoE-/- mice.
Yu H, Jiao X, Yang Y, Lv Q, Du Z, Li L, Hu C, Du Y, Zhang J, Li F, Sun Q, Wang Y, Chen D, Zhang X, Qin Y
Clin Sci (Lond) 2023 Jun 28;137(12):979-993. doi: 10.1042/CS20230031. PMID: 37294581Free PMC Article
Male-female differences in acute thoracic aortic dissection: a systematic review and meta-analysis.
Meccanici F, Gökalp AL, Thijssen CGE, Mokhles MM, Bekkers JA, van Kimmenade R, Verhagen HJ, Roos-Hesselink JW, Takkenberg JJM
Interact Cardiovasc Thorac Surg 2022 Mar 31;34(4):616-627. doi: 10.1093/icvts/ivab270. PMID: 34664071Free PMC Article
Aortic diseases and obstructive sleep apnea.
Takagi H, Umemoto T
Int Angiol 2016 Oct;35(5):433-9. Epub 2015 Jul 29 PMID: 26221978

Prognosis

Risk prediction for thoracic aortic dissection: Is it time to go with the flow?
Salmasi MY, Pirola S, Asimakopoulos G, Nienaber C, Athanasiou T; London Aortic Mechanobiology Working Group
J Thorac Cardiovasc Surg 2023 Oct;166(4):1034-1042. Epub 2022 May 16 doi: 10.1016/j.jtcvs.2022.05.016. PMID: 35672182
Thoracic Aortic Aneurysm: A Clinical Review.
Senser EM, Misra S, Henkin S
Cardiol Clin 2021 Nov;39(4):505-515. doi: 10.1016/j.ccl.2021.06.003. PMID: 34686263
Acute Chest Pain in Adults: Outpatient Evaluation.
McConaghy JR, Sharma M, Patel H
Am Fam Physician 2020 Dec 15;102(12):721-727. PMID: 33320506
Predictive imaging for thoracic aortic dissection and rupture: moving beyond diameters.
Adriaans BP, Wildberger JE, Westenberg JJM, Lamb HJ, Schalla S
Eur Radiol 2019 Dec;29(12):6396-6404. Epub 2019 Jul 5 doi: 10.1007/s00330-019-06320-7. PMID: 31278573Free PMC Article
Biomarkers in descending thoracic aortic dissection.
Shalhub S, Dua A, Brooks J
Semin Vasc Surg 2014 Dec;27(3-4):196-9. Epub 2015 Jan 16 doi: 10.1053/j.semvascsurg.2015.01.001. PMID: 26073830

Clinical prediction guides

Causal Role for Neutrophil Elastase in Thoracic Aortic Dissection in Mice.
Yang M, Zhou X, Pearce SWA, Yang Z, Chen Q, Niu K, Liu C, Luo J, Li D, Shao Y, Zhang C, Chen D, Wu Q, Cutillas PR, Zhao L, Xiao Q, Zhang L
Arterioscler Thromb Vasc Biol 2023 Oct;43(10):1900-1920. Epub 2023 Aug 17 doi: 10.1161/ATVBAHA.123.319281. PMID: 37589142Free PMC Article
HTAD patient pathway: Strategy for diagnostic work-up of patients and families with (suspected) heritable thoracic aortic diseases (HTAD). A statement from the HTAD working group of VASCERN.
Caruana M, Baars MJ, Bashiardes E, Benke K, Björck E, Codreanu A, de Moya Rubio E, Dumfarth J, Evangelista A, Groenink M, Kallenbach K, Kempers M, Keravnou A, Loeys B, Muiño-Mosquera L, Nagy E, Milleron O, Nistri S, Pepe G, Roos-Hesselink J, Szabolcs Z, Teixidó-Tura G, Timmermans J, Van de Laar I, van Kimmenade R, Verstraeten A, Von Kodolitsch Y, De Backer J, Jondeau G
Eur J Med Genet 2023 Jan;66(1):104673. Epub 2022 Nov 29 doi: 10.1016/j.ejmg.2022.104673. PMID: 36460281
Methamphetamine induces thoracic aortic aneurysm/dissection through C/EBPβ.
Luo BY, Zhou J, Guo D, Yang Q, Tian Q, Cai DP, Zhou RM, Xu ZZ, Wang HJ, Chen SY, Xie WB
Biochim Biophys Acta Mol Basis Dis 2022 Sep 1;1868(9):166447. Epub 2022 May 25 doi: 10.1016/j.bbadis.2022.166447. PMID: 35643386Free PMC Article
Thoracic Aortic Aneurysm: A Clinical Review.
Senser EM, Misra S, Henkin S
Cardiol Clin 2021 Nov;39(4):505-515. doi: 10.1016/j.ccl.2021.06.003. PMID: 34686263
Acute Chest Pain in Adults: Outpatient Evaluation.
McConaghy JR, Sharma M, Patel H
Am Fam Physician 2020 Dec 15;102(12):721-727. PMID: 33320506

Recent systematic reviews

Comparison of Chimney and Fenestrated Techniques for Supra-Aortic Branch Revascularization During Thoracic Endovascular Aortic Repair: A Systematic Review and Meta-Analysis.
Liu M, Wu X, Wu S, Li X, Xin S, Zhang J
Cardiovasc Intervent Radiol 2023 Oct;46(10):1315-1328. Epub 2023 Sep 8 doi: 10.1007/s00270-023-03537-4. PMID: 37684487
Is There Enough Evidence to Support the Role of Glycosaminoglycans and Proteoglycans in Thoracic Aortic Aneurysm and Dissection?-A Systematic Review.
Rai P, Robinson L, Davies HA, Akhtar R, Field M, Madine J
Int J Mol Sci 2022 Aug 16;23(16) doi: 10.3390/ijms23169200. PMID: 36012466Free PMC Article
Methods and Outcomes of Endovascular False Lumen Embolization for Thoracic Aortic Dissection.
Li HL, Chan YC, Jia HY, Cheng SW
Ann Vasc Surg 2022 Sep;85:371-382. Epub 2022 Mar 24 doi: 10.1016/j.avsg.2022.03.020. PMID: 35339592
Male-female differences in acute thoracic aortic dissection: a systematic review and meta-analysis.
Meccanici F, Gökalp AL, Thijssen CGE, Mokhles MM, Bekkers JA, van Kimmenade R, Verhagen HJ, Roos-Hesselink JW, Takkenberg JJM
Interact Cardiovasc Thorac Surg 2022 Mar 31;34(4):616-627. doi: 10.1093/icvts/ivab270. PMID: 34664071Free PMC Article
Echocardiographic aortic root dilatation in hypertensive patients: a systematic review and meta-analysis.
Covella M, Milan A, Totaro S, Cuspidi C, Re A, Rabbia F, Veglio F
J Hypertens 2014 Oct;32(10):1928-35; discussion 1935. doi: 10.1097/HJH.0000000000000286. PMID: 24979304

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