Aortic dissection

Ensure that imaging of the aorta is performed before discharge.[5]Fleischmann D, Afifi RO, Casanegra AI, et al. Imaging and surveillance of chronic aortic dissection: a scientific statement from the American Heart Association. Circ Cardiovasc Imaging. 2022 Mar;15(3):e000075. https://www.ahajournals.org/doi/full/10.1161/HCI.0000000000000075?rfr_dat=cr_pub++0pubmed&url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org http://www.ncbi.nlm.nih.gov/pubmed/35172599?tool=bestpractice.com ​

The time intervals recommended for surveillance imaging with computed tomography angiography (CTA) or magnetic resonance angiography (MRA) in patients with chronic aortic dissection vary across guidelines and should be tailored for individual patients.[5]Fleischmann D, Afifi RO, Casanegra AI, et al. Imaging and surveillance of chronic aortic dissection: a scientific statement from the American Heart Association. Circ Cardiovasc Imaging. 2022 Mar;15(3):e000075. https://www.ahajournals.org/doi/full/10.1161/HCI.0000000000000075?rfr_dat=cr_pub++0pubmed&url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org http://www.ncbi.nlm.nih.gov/pubmed/35172599?tool=bestpractice.com

The European Society of Cardiology (ESC) recommends:[2]Erbel R, Aboyans V, Boileau C, et al; ESC Committee for Practice Guidelines. 2014 ESC guidelines on the diagnosis and treatment of aortic diseases: document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. Eur Heart J. 2014 Nov 1;35(41):2873-926. https://academic.oup.com/eurheartj/article/35/41/2873/407693/2014-ESC-Guidelines-on-the-diagnosis-and-treatment http://www.ncbi.nlm.nih.gov/pubmed/25173340?tool=bestpractice.com

• Patients with uncomplicated aortic dissection who are having medical management should be followed up at 6 months after diagnosis.

• Patients who have undergone thoracic endovascular aortic repair (TEVAR) should be followed up with imaging at 1, 6, and 12 months postoperatively, and then annually thereafter. If an abnormality is detected, shorter intervals may be required.

• Computed tomography angiography (CTA) is recommended as the imaging of choice for follow-up of patients who have undergone TEVAR. However, MRI is preferred in younger patients if they have magnetic-resonance compatible stent grafts, to reduce radiation exposure.

• Patients who have undergone open surgery can have follow-up at approximately 5-year intervals with doppler ultrasound or CTA.[2]Erbel R, Aboyans V, Boileau C, et al; ESC Committee for Practice Guidelines. 2014 ESC guidelines on the diagnosis and treatment of aortic diseases: document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. Eur Heart J. 2014 Nov 1;35(41):2873-926. https://academic.oup.com/eurheartj/article/35/41/2873/407693/2014-ESC-Guidelines-on-the-diagnosis-and-treatment http://www.ncbi.nlm.nih.gov/pubmed/25173340?tool=bestpractice.com