Review Article
2021 Nov, 78 (21) 2106–2125
JOURNAL：J Am Coll Cardiol.
Article Link
Acute Aortic Syndrome Revisited: JACC State-of-the-Art Review
I Vilacosta, JAS Román , R di Bartolomeo et al.
KEYWORDS
acute aortic syndrome; epidemiology; diagnostic strategy; disease management
The purpose of this paper is to describe all available evidence on the
distinctive features of a group of 4 life-threatening acute aortic
pathologies gathered under the name of acute aortic syndrome (AAS). The
epidemiology, diagnostic strategy, and management of these patients has
been updated. The authors propose a new and simple diagnostic algorithm
to support clinical decision making in cases of suspected AAS, thereby
minimizing diagnostic delays, misdiagnoses, and unnecessary advanced
imaging. AAS-related entities are reviewed, and a guideline to avoid
imaging misinterpretation is provided. Centralization of patients with
AAS in high-volume centers with high-volume surgeons is key to improving
clinical outcomes. Thus, the role of multidisciplinary teams, an “aorta
code” (streamlined emergent care pathway), and aortic centers in the
management of these patients is boosted. A tailored patient treatment
approach for each of these acute aortic entities is needed, and as such
has been summarized. Finally, a set of prevention measures against AAS
is discussed.
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