Thoracoabdominal Aortic Disease and Repair: JACC Focus Seminar, Part 3

J Am Coll Cardiol. 2022 Aug 23;80(8):845-856. doi: 10.1016/j.jacc.2021.05.056.

Abstract

Thoracoabdominal aortic disease is a rare but life-threatening condition that requires expert multidisciplinary collaborative management. Intervention is indicated in patients with symptomatic aneurysms or when an aneurysm reaches a certain threshold of diameter or rate of expansion. The strategies for spinal cord and end-organ protection have evolved over several decades, resulting in improved outcomes after repair. Open repair, although invasive, provides definitive and durable repair. Endovascular approaches are rapidly evolving, and the results with fenestrated and branched endografts are promising. Both open repair and endovascular repair require highly specialized expertise, and outcomes are best when repair is undertaken in an elective setting by a dedicated team. Patients with degenerative thoracoabdominal aortic aneurysms and chronic dissections should be followed up closely and referred for elective repair when indicated.

Keywords: aortic aneurysm; dissection; endovascular; thoracoabdominal aneurysm.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aortic Aneurysm, Thoracic* / diagnosis
  • Aortic Aneurysm, Thoracic* / surgery
  • Blood Vessel Prosthesis
  • Blood Vessel Prosthesis Implantation*
  • Endovascular Procedures*
  • Humans
  • Postoperative Complications / surgery
  • Prosthesis Design
  • Risk Factors
  • Time Factors
  • Treatment Outcome