Author + information
- Received July 9, 2019
- Accepted July 26, 2019
- Published online September 9, 2019.
- Rami O. Tadros, MDa,∗ (, )@vascMD,
- Gilbert H.L. Tang, MD, MSc, MBAb,
- Hanna J. Barnes, BAa,
- Idine Mousavi, BAa,
- Jason C. Kovacic, MD, PhDc,
- Peter Faries, MDa,
- Jeffrey W. Olin, DOc,
- Michael L. Marin, MDa and
- David H. Adams, MDb
- aDivision of Vascular Surgery, Department of Surgery, Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York, New York
- bDepartment of Cardiovascular Surgery, Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York, New York
- cDivision of Cardiology, Department of Medicine, Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, New York, New York
- ↵∗Address for correspondence:
Dr. Rami O. Tadros, Department of Surgery, Division of Vascular Surgery, The Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue, 4th Floor, New York, New York 10029.
• Most type B aortic dissections that are medically managed progress to aneurysms.
• Aneurysms increase the incidence of aorta related adverse events and mortality.
• Early thoracic endovascular aortic repair improves the rate of favorable aortic remodeling, which is protective against aneurysm formation.
• Randomized trials are needed to further define the benefits of early thoracic endovascular aortic repair in type B aortic dissection.
Historically, the gold standard for treating acute uncomplicated type B aortic dissection (TBAD) has been aggressive medical therapy to achieve optimal heart rate and blood pressure control. However, recent data have demonstrated that a significant proportion of patients with medically managed acute uncomplicated TBAD have late aorta-related complications, such as aneurysmal degeneration, that increase mortality and often necessitate surgical intervention. In this review, the authors review existing literature on uncomplicated TBAD and highlight contemporary surgical and medical strategies to manage this condition. Looking ahead, efforts are underway to identify and characterize a high-risk subgroup of acute uncomplicated TBAD patients who may benefit from early intervention.
All funds for this manuscript were provided by the Icahn School of Medicine at Mount Sinai. Dr. Kovacic receives honoraria and has received research grants from Medtronic. Dr. Marin has served as a consultant for W.L. Gore. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
Listen to this manuscript's audio summary by Editor-in-Chief Dr. Valentin Fuster on JACC.org.
- Received July 9, 2019.
- Accepted July 26, 2019.
- 2019 American College of Cardiology Foundation
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