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Aortic Diseases

ESC Clinical Practice Guidelines

Document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult.

In addition to coronary and peripheral artery diseases, aortic diseases contribute to the wide spectrum of arterial diseases: aortic aneurysms, acute aortic syndromes (AAS) including aortic dissection (AD), intramural haematoma (IMH), penetrating atherosclerotic ulcer (PAU) and traumatic aortic injury (TAI), pseudoaneurysm, aortic rupture, atherosclerotic and inflammatory affections, as well as genetic diseases (e.g. Marfan syndrome) and congenital abnormalities including the coarctation of the aorta (CoA).

Diseases of the Aorta
Cardiovascular Surgery
Acute Cardiac Care
Guidelines version available to download
Published in 2014
Reference Eur Heart J 2014;35:2873-2926 - Eur Heart J doi:10.1093/eurheartj/ehu281
Published in 2014
Reference ESC Guidelines on Aortic Diseases Web Addenda
Published in 2014
Reference 2014 Take Home Messages & Gaps in Evidence
Published in 2014
Reference Pocket Guidelines Abriged version
  • PDA
  • Published in 2014
    Reference Aortic Pocket Guidelines Mobile App
    Published in 2014
    Reference 56 Slides 2014 Aortic Diseases
    Published in 2014
    Reference 36 CME Questions
    Published in 2001
    Reference Eur Heart J; 22:1642-1681
    Authors

    R. Erbel FESC (Chairperson), Victor Aboyans (Chairperson), Edduardo Bossone (Itatly), Roberto Di Bartolomeo (Italy),Holger Eggebrecht (Germany), Arturo Evangelista (Spain), Volkmar Falk (Switzerland), Herbert Franck  (Austria), Oliver Gaemperli (Switzerland), Martin Grabenwoeger (Austria), Axel Haverich (Germany), Bernard Iung (France), Anathasios John Manolis (Greece), Folkert Meijboom (Netherlands), Christoph  A. Nienaber (Germany), Marco Roffi (Switzerland), Hervé Rousseau (France), Udo Sechtem (Germany), Per Anton Sirnes (Norvay), Regula S. von Allmen (Switzerland) and Christi J.M. Vrints (Belgium)

    Table of contents: Full Text (ESC Clinical Practice Guidelines)

    Preamble
    Introduction
    The normal and the ageing aorta
    Assessment of the aorta

        Clinical examination
        Laboratory testing
        Imaging
            Chest X-ray
            Ultrasound
            Computed tomography
            Positron emission tomography/computed tomography
            Magnetic resonance imaging
            Aortography
            Intravascular ultrasound

         Assessment of aortic stiffness

    Treatment options

        Principles of medical therapy
        Endovascular therapy
            Thoracic endovascular aortic repair
            Abdominal endovascular aortic repair

    Surgery

            Ascending aorta
            Aortic arch
            Thoracoabdominal aorta
            Abdominal aorta

    Acute thoracic aortic syndromes

        Definition
        Pathology and classification
        Acute aortic dissection
            Definition and classification
            Epidemiology
            Clinical presentation and complications
            Laboratory testing
            Diagnostic imaging in acute aortic dissection
            Diagnostic work-up
            Treatment

        Intramural haematoma
            Definition
            Diagnosis
            Natural history, morphological changes, and complications
            Indications for surgery and thoracic endovascular aortic repair

        Penetrating aortic ulcer
            Definition
            Diagnostic imaging
            Management
            Interventional therapy

        Aortic pseudoaneurysm
        (Contained) rupture of aortic aneurysm
            Contained rupture of thoracic aortic aneurysm

        Traumatic aortic injury
            Definition, epidemiology and classification
            Patient presentation and diagnosis
            Indications for treatment in traumatic aortic injury
            Medical therapy in traumatic aortic injury
            Surgery in traumatic aortic injury
            Endovascular therapy in traumatic aortic injury
            Long-term surveillance in traumatic aortic injury

        Iatrogenic aortic dissection

    Aortic aneurysms

        Thoracic aortic aneurysms
        Abdominal aortic aneurysm
            Definition
            Risk factors
            Natural history
            Diagnosis
            Abdominal aortic aneurysm repair
            Long-term prognosis and follow-up of aortic aneurysm repair

    Genetic diseases affecting the aorta

         Chromosomal and inherited syndromic thoracic aortic aneurysms and dissection
        Aortic diseases associated with bicuspid aortic valve
        Coarctation of the aorta

    Atherosclerotic lesions of the aorta

        Thromboembolic aortic disease
        Mobile aortic thrombosis
        Atherosclerotic aortic occlusion
        Calcified aorta
        Coral reef aorta

    Aortitis

        Definition, types, and diagnosis
        Treatment

    Aortic tumours

        Primary malignant tumours of the aorta

    Long-term follow-up of aortic diseases

        Chronic aortic dissection
        Follow-up after thoracic aortic intervention
        Follow-up of patients after intervention for abdominal aortic aneurysm

    Gaps in evidence

    Appendix

    Web addenda – All web figures and web tables are available in the online addenda

    References


     

     

     

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