Surgery for Aortic Dilatation in Patients With Bicuspid Aortic Valves: A Statement of Clarification From the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines

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• 作者：Loren F. Hiratzka ; MD ; FACC ; FAHA^&lowast ; (Chair ; 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis ; Management of Patients With Thoracic Aortic Disease Representative) ; Mark A. Creager ; MD ; FACC ; FAHA^&lowast ; ; ^&dagger ; (2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis ; Management of Patients With Thoracic Aortic Disease Representative Member) ; Eric M. Isselbacher ; MD ; FACC^&lowast ; (2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis ; Management of Patients With Thoracic Aortic Disease Representative Member) ; Lars G. Svensson ; MD ; PhD ; FACC^&lowast ; (2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis ; Management of Patients With Thoracic Aortic Disease Representative Member)
• 关键词：ACC/AHA Clinical Practice Guidelines ; anticoagulation therapy ; heart valves ; thoracic aortic aneurysm ; thoracic aortic disease ; thoracic aortic dissection ; valvular heart disease
• 刊名：Journal of the American College of Cardiology
• 出版年：2016
• 出版时间：16 February 2016
• 年：2016
• 卷：67
• 期：6
• 页码：724-731
• 全文大小：954 K

文摘

Two guidelines from the American College of Cardiology (ACC), the American Heart Association (AHA), and collaborating societies address the risk of aortic dissection in patients with bicuspid aortic valves and severe aortic enlargement: the “2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease” (J Am Coll Cardiol 2010;55:e27–130) and the “2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease” (J Am Coll Cardiol 2014;63:e57–185). However, the 2 guidelines differ with regard to the recommended threshold of aortic root or ascending aortic dilatation that would justify surgical intervention in patients with bicuspid aortic valves. The ACC and AHA therefore convened a subcommittee representing members of the 2 guideline writing committees to review the evidence, reach consensus, and draft a statement of clarification for both guidelines. This statement of clarification uses the ACC/AHA revised structure for delineating the Class of Recommendation and Level of Evidence to provide recommendations that replace those contained in Section 9.2.2.1 of the thoracic aortic disease guideline and Section 5.1.3 of the valvular heart disease guideline.