2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease

ACCF/AHA Task Force Members Alice K. Jacobs, MD, FACC, FAHA, Chair 2009-2011; Sidney C. Smith, Jr, MD, FACC, FAHA, Immediate Past Chair 2006-2008[dagger][dagger][dagger]; Jeffery L. Anderson, MD, FACC, FAHA, Chair-Elect; Cynthia D. Adams, MSN, PhD, FAHA[dagger][dagger][dagger]; Christopher E. Buller, MD, FACC; Mark A. Creager, MD, FACC, FAHA; Steven M. Ettinger, MD, FACC; Robert A. Guyton, MD, FACC, FAHA; Jonathan L. Halperin, MD, FACC, FAHA; Sharon A. Hunt, MD, FACC, FAHA[dagger][dagger][dagger]; Harlan M. Krumholz, MD, FACC, FAHA[dagger][dagger][dagger]; Frederick G. Kushner, MD, FACC, FAHA; Bruce W. Lytle, MD, FACC, FAHA[dagger][dagger][dagger]; Rick Nishimura, MD, FACC, FAHA[dagger][dagger][dagger]; Richard L. Page, MD, FACC, FAHA[dagger][dagger][dagger]; Barbara Riegel, DNSc, RN, FAHA***; William G. Stevenson, MD, FACC, FAHA; Lynn G. Tarkington, RN; Clyde W. Yancy, MD, FACC, FAHA Table of Contents Preamble...e31 Introduction...e31 Methodology and Evidence Review...e31 Organization of the Writing Committee...e32 Document Review and Approval...e32 Scope of the Guideline...e33 Critical Issues...e35 Glossary of Terms and Abbreviations Used Throughout Guideline...e35 The Thoracic Aorta...e36 The Normal Aorta...e36 Normal Thoracic Aortic Diameter...e36 Thoracic Aortic Histopathology...e37 Atherosclerosis...e37 Aneurysms and Dissections...e37 Vasculitis and Inflammatory Diseases...e38 Imaging Modalities...e39 Recommendations for Aortic Imaging Techniques to Determine the Presence and Progression of Thoracic Aortic Disease...e39 Chest X-Ray...e40 Computed Tomographic Imaging...e40 Computed Tomographic Imaging Technique...e42 Magnetic Resonance Imaging...e42 Magnetic Resonance Imaging Technique ...e43 Black Blood Imaging...e43 Noncontrast White Blood Imaging...e43 Contrast-Enhanced Magnetic Resonance Angiography...e43 Phase Contrast Imaging...e43 Standards for Reporting of the Thoracic Aorta on Computed Tomography and Magnetic Resonance Imaging...e43 Angiography...e44 Echocardiography...e45 Echocardiographic Criteria for Thoracic Aortic Aneurysms...e45 Echocardiographic Criteria for Aortic Dissection...e45 Diagnostic Accuracy of Echocardiography for Aortic Dissection...e46 Diagnostic Accuracy of Echocardiography for Acute Intramural Hematoma...e46 Role of Echocardiography in Following Patients With Chronic Aortic Disease...e47 Genetic Syndromes Associated With Thoracic Aortic Aneurysms and Dissections...e47 Recommendations for Genetic Syndromes...e47 Marfan Sy