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J Am Coll Cardiol. 2014 Oct 21;64(16):1725-39. doi: 10.1016/j.jacc.2014.08.025.

Thoracic aortic aneurysm and dissection.

Author information

1
Department of Medicine, Division of Cardiology, Zena and Michael A. Wiener Cardiovascular Institute and Marie-Josée and Henry R. Kravis Center for Cardiovascular Health, Icahn School of Medicine at Mount Sinai, New York, New York.
2
Department of Surgery, Division of Vascular Surgery, Icahn School of Medicine at Mount Sinai, New York, New York.
3
Department of Cardiothoracic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York.
4
Department of Medicine, Samuel and Jean A. Frankel Cardiovascular Center, University of Michigan Health System and Medical School, Ann Arbor, Michigan.
5
Department of Medicine, Division of Cardiology, Zena and Michael A. Wiener Cardiovascular Institute and Marie-Josée and Henry R. Kravis Center for Cardiovascular Health, Icahn School of Medicine at Mount Sinai, New York, New York. Electronic address: valentin.fuster@mountsinai.org.

Abstract

Aortic dissection is the most devastating complication of thoracic aortic disease. In the more than 250 years since thoracic aortic dissection was first described, much has been learned about diseases of the thoracic aorta. In this review, we describe normal thoracic aortic size; risk factors for dissection, including genetic and inflammatory conditions; the underpinnings of genetic diseases associated with aneurysm and dissection, including Marfan syndrome and the role of transforming growth factor beta signaling; data on the role for medical therapies in aneurysmal disease, including beta-blockers, angiotensin receptor blockers, and angiotensin-converting enzyme inhibitors; prophylactic surgery for aneurysm; surgical techniques for the aortic root; and surgical and endovascular management of aneurysm and dissection for different aortic segments.

KEYWORDS:

Marfan syndrome; aortic aneurysm; cardiac surgical procedures; endovascular procedures; risk factors; transforming growth factor beta

PMID:
25323262
DOI:
10.1016/j.jacc.2014.08.025
[Indexed for MEDLINE]
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