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HomeCirculationAhead of Print2022 ACC/AHA Guideline for the Diagnosis and
Management of Aortic Disease: A Report of the American Heart
Association/American College of Cardiology Joint Committee on Clinical Practice
Guidelines
Free AccessReview Article
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Free AccessReview Article
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2022 ACC/AHA GUIDELINE FOR THE DIAGNOSIS AND MANAGEMENT OF AORTIC DISEASE: A
REPORT OF THE AMERICAN HEART ASSOCIATION/AMERICAN COLLEGE OF CARDIOLOGY JOINT
COMMITTEE ON CLINICAL PRACTICE GUIDELINES
* Eric M. Isselbacher
, MD, MSc, FACC,
* Ourania Preventza
, MD, MBA,
* James Hamilton Black, III
, MD, DFSVS,
* John G. Augoustides
, MD, FAHA,
* Adam W. Beck
, MD, DFSVS;,
* Michael A. Bolen
, MD,
* Alan C. Braverman
, MD, FACC,
* Bruce E. Bray
, MD, FACC,
* Maya M. Brown-Zimmerman
, MPH,
* Edward P. Chen
, MD, FAHA,
* Tyrone J. Collins
, MD, MSCAI, FACC, FAHA, FSVM,
* Abe DeAnda, Jr
, MD, FAHA,
* Christina L. Fanola
, MD, MSc,
* Leonard N. Girardi
, MD, FAHA,
* Caitlin W. Hicks
, MD, MS, FSVS,
* Dawn S. Hui
, MD,
* William Schuyler Jones
, MD, FACC,
* Vidyasagar Kalahasti
, MD, FACC,
* Karen M. Kim
, MD, MS,
* Dianna M. Milewicz
, MD, PhD,
* Gustavo S. Oderich
, MD,
* Laura Ogbechie
, MSN,
* Susan B. Promes
, MD, MBA,
* Elsie Gyang Ross
, MD, MSc,
* Marc L. Schermerhorn
, MD, DFSVS,
* Sabrina Singleton Times
, DHSc, MPH,
* Elaine E. Tseng
, MD, FAHA,
* Grace J. Wang
, MD, MSCE and
* Y. Joseph Woo
, MD, FACC, FAHA
Eric M. Isselbacher
Eric M. Isselbacher
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,
Ourania Preventza
Ourania Preventza
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,
James Hamilton Black, III
James Hamilton Black, III
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,
John G. Augoustides
John G. Augoustides
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,
Adam W. Beck
Adam W. Beck
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,
Michael A. Bolen
Michael A. Bolen
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,
Alan C. Braverman
Alan C. Braverman
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,
Bruce E. Bray
Bruce E. Bray
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,
Maya M. Brown-Zimmerman
Maya M. Brown-Zimmerman
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,
Edward P. Chen
Edward P. Chen
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,
Tyrone J. Collins
Tyrone J. Collins
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Abe DeAnda, Jr
Abe DeAnda, Jr
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Christina L. Fanola
Christina L. Fanola
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,
Leonard N. Girardi
Leonard N. Girardi
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,
Caitlin W. Hicks
Caitlin W. Hicks
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Dawn S. Hui
Dawn S. Hui
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,
William Schuyler Jones
William Schuyler Jones
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Vidyasagar Kalahasti
Vidyasagar Kalahasti
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Karen M. Kim
Karen M. Kim
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Originally published2 Nov
2022https://doi.org/10.1161/CIR.0000000000001106Circulation. 2022;0
ABSTRACT
AIM:
The “2022 ACC/AHA Guideline for the Diagnosis and Management of Aortic Disease”
provides recommendations to guide clinicians in the diagnosis, genetic
evaluation and family screening, medical therapy, endovascular and surgical
treatment, and long-term surveillance of patients with aortic disease across its
multiple clinical presentation subsets (ie, asymptomatic, stable symptomatic,
and acute aortic syndromes).
METHODS:
A comprehensive literature search was conducted from January 2021 to April 2021,
encompassing studies, reviews, and other evidence conducted on human subjects
that were published in English from PubMed, EMBASE, the Cochrane Library, CINHL
Complete, and other selected databases relevant to this guideline. Additional
relevant studies, published through June 2022 during the guideline writing
process, were also considered by the writing committee, where appropriate.
STRUCTURE:
Recommendations from previously published AHA/ACC guidelines on thoracic aortic
disease, peripheral artery disease, and bicuspid aortic valve disease have been
updated with new evidence to guide clinicians. In addition, new recommendations
addressing comprehensive care for patients with aortic disease have been
developed. There is added emphasis on the role of shared decision making,
especially in the management of patients with aortic disease both before and
during pregnancy. The is also an increased emphasis on the importance of
institutional interventional volume and multidisciplinary aortic team expertise
in the care of patients with aortic disease.
FOOTNOTES
ACC/AHA Joint Committee on Clinical Practice Guidelines Members, see page ***.
The American Heart Association requests that this document be cited as follows:
Isselbacher EM, Preventza O, Black JH 3rd, Augoustides JG, Beck AW, Bolen MA,
Braverman AC, Bray BE, Brown-Zimmerman MM, Chen EP, Collins TJ, DeAnda A Jr,
Fanola CL, Girardi LN, Hicks CW, Hui DS, Jones WS, Kalahasti V, Kim KM, Milewicz
DM, Oderich GS, Ogbechie L, Promes SB, Ross EG, Schermerhorn ML, Times SS, Tseng
EE, Wang GJ, Woo YJ. 2022 ACC/AHA guideline for the diagnosis and management of
aortic disease: a report of the American Heart Association/American College of
Cardiology Joint Committee on Clinical Practice Guidelines. Circulation.
2022;146:e•••–e•••. doi: 10.1161/CIR.0000000000001106
This document was approved by the American College of Cardiology Clinical Policy
Approval Committee and the American Heart Association Science Advisory and
Coordinating Committee in July 2022, the American College of Cardiology Science
and Quality Committee in August 2022, and the American Heart Association
Executive Committee in September 2022.
This article has been copublished in the Journal of the American College of
Cardiology.
Copies: This document is available on the websites of the American College of
Cardiology (www.acc.org) and the American Heart Association
(professional.heart.org). A copy of the document is also available at
https://professional.heart.org/statements by selecting the “Guidelines &
Statements” button. To purchase additional reprints, call 215-356-2721 or email
Meredith.Edelman@wolterskluwer.com.
The expert peer review of AHA-commissioned documents (eg, scientific statements,
clinical practice guidelines, systematic reviews) is conducted by the AHA Office
of Science Operations. For more on AHA statements and guidelines development,
visit https://professional.heart.org/statements. Select the “Guidelines &
Statements” drop-down menu near the top of the webpage, then click “Publication
Development.”
Permissions: Multiple copies, modification, alteration, enhancement, and
distribution of this document are not permitted without the express permission
of the American Heart Association. Instructions for obtaining permission are
located at https://www.heart.org/permissions. A link to the “Copyright
Permissions Request Form” appears in the second paragraph
(https://www.heart.org/en/about-us/statements-and-policies/copyright-request-form).
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* Recommended
* 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM GUIDELINES FOR THE
DIAGNOSIS AND MANAGEMENT OF PATIENTS WITH THORACIC AORTIC DISEASE
* ,
* Loren F. Hiratzka,
* George L. Bakris,
* Joshua A. Beckman,
* Robert M. Bersin,
* Vincent F. Carr,
* Donald E. Casey,
* Kim A. Eagle,
* Luke K. Hermann,
* Eric M. Isselbacher,
* Ella A. Kazerooni,
* Nicholas T. Kouchoukos,
* Bruce W. Lytle,
* Dianna M. Milewicz,
* David L. Reich,
* Souvik Sen,
* Julie A. Shinn,
* Lars G. Svensson and
* David M. Williams
WRITING GROUP MEMBERS
Vol. 121, No. 13 March 2010
* 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM GUIDELINES FOR THE
DIAGNOSIS AND MANAGEMENT OF PATIENTS WITH THORACIC AORTIC DISEASE:
EXECUTIVE SUMMARY
* ,
* Loren F. Hiratzka,
* George L. Bakris,
* Joshua A. Beckman,
* Robert M. Bersin,
* Vincent F. Carr,
* Donald E. Casey,
* Kim A. Eagle,
* Luke K. Hermann,
* Eric M. Isselbacher,
* Ella A. Kazerooni,
* Nicholas T. Kouchoukos,
* Bruce W. Lytle,
* Dianna M. Milewicz,
* David L. Reich,
* Souvik Sen,
* Julie A. Shinn,
* Lars G. Svensson and
* David M. Williams
WRITING COMMITTEE MEMBERS
Vol. 121, No. 13 March 2010
* SURGICAL MANAGEMENT OF DESCENDING THORACIC AORTIC DISEASE: OPEN AND
ENDOVASCULAR APPROACHES
* Michael A. Coady,
* John S. Ikonomidis,
* Albert T. Cheung,
* Alan H. Matsumoto,
* Michael D. Dake,
* Elliot L. Chaikof,
* Richard P. Cambria,
* Christina T. Mora-Mangano,
* Thoralf M. Sundt,
* Frank W. Sellke
*
and on behalf of the American Heart Association Council on Cardiovascular
Surgery and Anesthesia and Council on Peripheral Vascular Disease
Vol. 121, No. 25 June 2010
* SURGICAL INDICATION FOR CHRONIC AORTIC DISSECTION IN DESCENDING THORACIC
AND THORACOABDOMINAL AORTA
* Tatsuya Oda,
* Kenji Minatoya,
* Hiroaki Sasaki,
* Hiroshi Tanaka,
* Yoshimasa Seike,
* Tatsuya Itonaga,
* Yosuke Inoue,
* Masahiro Higashi,
* Kunihiro Nishimura and
* Junjiro Kobayashi
Vol. 10, No. 2 February 2017
* IN SITU LASER FENESTRATION IS A FEASIBLE METHOD FOR REVASCULARIZATION OF
AORTIC ARCH DURING THORACIC ENDOVASCULAR AORTIC REPAIR
* Jinbao Qin,
* Zhen Zhao,
* Ruihua Wang,
* Kaichuang Ye,
* Weimin Li,
* Xiaobing Liu,
* Guang Liu,
* Chaoyi Cui,
* Huihua Shi,
* Zhiyou Peng,
* Fukang Yuan,
* Xinrui Yang,
* Min Lu,
* Xintian Huang,
* Mier Jiang,
* Xin Wang,
* Minyi Yin and
* Xinwu Lu
Vol. 6, No. 4 April 2017
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* © 2022 by the American College of Cardiology Foundation and the American
Heart Association, Inc.
https://doi.org/10.1161/CIR.0000000000001106
PMID: 36322642
* Originally publishedNovember 2, 2022
Keywords
* heritable thoracic aortic disease
* bicuspid aortic valve
* AHA Scientific Statements
* endovascular aortic repair
* thoracic endovascular aortic repair
* thoracic aortic aneurysm
* malperfusion syndrome
* aortic dissection
* thoracoabdominal aortic aneurysm
* penetrating atherosclerotic ulcer
* intramural hematoma
* abdominal aortic aneurysm
* guidelines
* blunt traumatic aortic injury
* Loeys-Dietz syndrome
* aortopathy
* vascular surgery
* cardiac surgery
* Marfan syndrome
* aortitis
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