Guideline for the Treatment of Thoracic Aortic Dissection Type A: Summary of the S2k Guideline

Introduction

Acute aortic dissection type A (AADA) is a devastating disease with high initial mortality. Patients surviving the initial event are transferred to a hospital and must be operated immediately, as proposed by current guidelines focusing on aortic disease in general.[1] [2] However, due to the emergent character and the heterogeneous clinical picture of the disease, neither universally valid standards nor specific guidelines for the surgical treatment of AADA exist.

Initiated by the German Society of Thoracic and Cardiovascular Surgery (DGTHG), the lack of a clinical guideline for the treatment of aortic dissection type A was addressed. Together with the German societies for vascular surgery (DGG), anesthesiology (DGAI), cardiology (DGK), radiology (DRG), and, representing the patient's interests, the German Marfan Aid Organization (Marfan Hilfe (Deutschland) e.V.), the guideline was developed and written under the moderation of the German Working Group of Scientific Medical Societies (AWMF).

Publication History

Received: 23 October 2022

Accepted: 27 October 2022

Article published online:
03 December 2022

• References

• 1 Erbel R, Aboyans V, Boileau C. et al; ESC Committee for Practice Guidelines, 2014. 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. The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC). Eur Heart J 2014; 35 (41) 2873-2926
• 2 Hiratzka LF, Bakris GL, Beckman JA. et al; American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, Society for Vascular Medicine, 2010. 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM guidelines for the diagnosis and management of patients with Thoracic Aortic Disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine. Circulation 2010; 121 (13) e266-e369
• 3 Kallenbach K, Berger T, Bürger T. et al. Behandlung der Thorakalen Aortendissektion Typ A. Thorac Cardiovasc Surg 2022; 70:Supplement S3
• 4 Habicher M, Zajonz T, Heringlake M. et al. S3 guidelines on intensive medical care of cardiac surgery patients : hemodynamic monitoring and cardiovascular system-an update [in German]. Anaesthesist 2018; 67 (05) 375-379