title: Canadian Cardiovascular Society position statement on the management of thoracic aortic disease.
abstract: This Canadian Cardiovascular Society position statement aims to provide succinct perspectives on key issues in the management of thoracic aortic disease (TAD). This document is not a comprehensive overview of TAD and important elements of the epidemiology, presentation, diagnosis, and management of acute aortic syndromes are deliberately not discussed; readers are referred to the 2010 guidelines published by the American Heart Association, American College of Cardiology, American Association for Thoracic Surgery, and other stakeholders. Rather, this document is a practical guide for clinicians managing adult patients with TAD. Topics covered include size thresholds for surgical intervention, emerging therapies, imaging modalities, medical and lifestyle management, and genetics of TAD. The primary panel consisted of experts from a variety of disciplines that are essential for comprehensive management of TAD patients. The methodology involved a focused literature review with an emphasis on updates since 2010 and the use of Grading of Recommendations Assessment, Development, and Evaluation methodology to arrive at specific recommendations. The final document then underwent review by a secondary panel. This document aims to provide recommendations for most patients and situations. However, the ultimate judgement regarding the management of any individual patients should be made by their health care team.
authors.affiliation: Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, Ontario, Canada. Electronic address: mboodhwani@ottawaheart.ca.
authors.forename: Munir
authors.initials: M
authors.lastname: Boodhwani
authors.affiliation: Department of Pediatrics, University of Montreal, Montreal, Québec, Canada.
authors.forename: Gregor
authors.initials: G
authors.lastname: Andelfinger
authors.affiliation: Department of Radiology, University of British Colombia, Vancouver, British Colombia, Canada.
authors.forename: Jonathon
authors.initials: J
authors.lastname: Leipsic
authors.affiliation: Division of Vascular Surgery, University Health Network, Toronto, Ontario, Canada.
authors.forename: Thomas
authors.initials: T
authors.lastname: Lindsay
authors.affiliation: Division of Cardiology, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: M Sean
authors.initials: MS
authors.lastname: McMurtry
authors.affiliation: Division of Cardiology, McGill University, Montreal, Québec, Canada.
authors.forename: Judith
authors.initials: J
authors.lastname: Therrien
authors.affiliation: Division of Cardiology, Western University, London, Ontario, Canada.
authors.forename: Samuel C
authors.initials: SC
authors.lastname: Siu
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000784:Aortic Dissection / Q000517:prevention & control / Q000601:surgery; D017541:Aneurysm, False / Q000601:surgery; D017542:Aneurysm, Ruptured / Q000150:complications; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001013:Aorta, Thoracic / Q000002:abnormalities / Q000473:pathology / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000235:genetics / Q000473:pathology* / Q000601:surgery*; D001021:Aortic Valve / Q000601:surgery; D001334:Automobile Driving; D006328:Cardiac Catheterization; D003324:Coronary Artery Disease / Q000517:prevention & control; D003657:Decision Making; D003952:Diagnostic Imaging; D004032:Diet; D004535:Ehlers-Danlos Syndrome / Q000150:complications / Q000175:diagnosis / Q000235:genetics; D057510:Endovascular Procedures; D015444:Exercise; D005260:Female; D005820:Genetic Testing; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D006973:Hypertension / Q000188:drug therapy / Q000517:prevention & control; D008019:Life Style; D055947:Loeys-Dietz Syndrome / Q000150:complications / Q000175:diagnosis / Q000235:genetics; D008382:Marfan Syndrome / Q000175:diagnosis / Q000188:drug therapy / Q000235:genetics / Q000601:surgery; D010348:Patient Care Team; D018579:Patient Selection; D011247:Pregnancy; D011300:Preoperative Care; D011785:Quality Assurance, Health Care; D018570:Risk Assessment; D016540:Smoking Cessation; D015607:Stents; D014424:Turner Syndrome / Q000150:complications / Q000175:diagnosis / Q000235:genetics
chemical_list: D000319:Adrenergic beta-Antagonists; D057911:Angiotensin Receptor Antagonists; D000959:Antihypertensive Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors