Thoracic aortic aneurysm medical therapy: Difference between revisions
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In certain populations, such as those with [[Marfan's syndrome]], patients with [[bicuspid aortic valve]] (especially when AVR is being considered), personal or family history of prior [[aortic dissection]], or those who have been documented on serial imaging studies to have rapidly expanding aneurysms, clinicians would perform repair sooner (size >4-5 cm for ascending and >5.5-6 cm for descending TAAs). | In certain populations, such as those with [[Marfan's syndrome]], patients with [[bicuspid aortic valve]] (especially when AVR is being considered), personal or family history of prior [[aortic dissection]], or those who have been documented on serial imaging studies to have rapidly expanding aneurysms, clinicians would perform repair sooner (size >4-5 cm for ascending and >5.5-6 cm for descending TAAs). | ||
==ACC/ AHA Guidelines - Recommendations for Medical treatment of patients with Thoracic aortic diseases (DO NOT EDIT)== | |||
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| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]] | |||
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|bgcolor="LightGreen" | '''1.''' Stringent control of hypertension, lipid profile optimization, smoking cessation, and other atherosclerosis risk-reduction measures should be instituted for patients with small aneurysms not requiring surgery, as well as for patients who are not considered surgical or stent graft candidates ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])'' | |||
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==References== | ==References== | ||
Revision as of 01:12, 9 October 2012
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Thoracic aortic aneurysm Microchapters |
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Differentiating Thoracic Aortic Aneurysm from other Diseases |
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Diagnosis |
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Treatment |
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Special Scenarios |
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Case Studies |
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Thoracic aortic aneurysm medical therapy On the Web |
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Directions to Hospitals Treating Thoracic aortic aneurysm medical therapy |
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Risk calculators and risk factors for Thoracic aortic aneurysm medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1], Amjad AlMahameed, MD, MPH, RPVI, FACP. Beth Israel Deaconess Medical Center and Harvard Medical School. Boston, USA
Associate Editor(s)-in-Chief: Aarti Narayan, M.B.B.S [2]
Overview
Medical Therapy
The goals of medical therapy include:
- Lowering BP to the lowest level tolerated
- Cessation of smoking
- Treat associated coronary and carotid artery disease
- Follow up:
- Using clinical and non-invasive imaging tests
- Initial at 3 months and then 6 monthly or yearly
TAA size is the primary indication for repair. Once a TAA reaches a pre-specified size (>5 cm in the ascending aorta, >6 cm in the descending segment) referral for surgical or endovascular repair sholuld be initiated. Most patients undergo repair once they reach >5.5 for ascending and >6.5 cm for descending TAA, respectively.
In certain populations, such as those with Marfan's syndrome, patients with bicuspid aortic valve (especially when AVR is being considered), personal or family history of prior aortic dissection, or those who have been documented on serial imaging studies to have rapidly expanding aneurysms, clinicians would perform repair sooner (size >4-5 cm for ascending and >5.5-6 cm for descending TAAs).
ACC/ AHA Guidelines - Recommendations for Medical treatment of patients with Thoracic aortic diseases (DO NOT EDIT)
| Class I |
| 1. Stringent control of hypertension, lipid profile optimization, smoking cessation, and other atherosclerosis risk-reduction measures should be instituted for patients with small aneurysms not requiring surgery, as well as for patients who are not considered surgical or stent graft candidates (Level of Evidence: A) |