Current options and recommendations for the use of thoracic endovascular aortic repair in acute and chronic thoracic aortic disease: an expert consensus document of the European Society for Cardiology (ESC) Working Group of Cardiovascular Surgery, the ESC Working Group on Aorta and Peripheral Vascular Diseases, the European Association of Percutaneous Cardiovascular Interventions (EAPCI) of the ESC and the European Association for Cardio-Thoracic Surgery (EACTS)

Author:

Czerny Martin1,Pacini Davide2ORCID,Aboyans Victor3,Al-Attar Nawwar4,Eggebrecht Holger5,Evangelista Arturo6,Grabenwöger Martin7,Stabile Eugenio8,Kolowca Maciej9,Lescan Mario10,Micari Antonio11ORCID,Muneretto Claudio12,Nienaber Christoph13ORCID,de Paulis Ruggero14ORCID,Tsagakis Konstantinos15,Rylski Bartosz1,Braverman Alan C,Di Marco Luca,Eagle Kim,Falk Volkmar,Gottardi Roman

Affiliation:

1. University Heart Center Freiburg—Bad Krozingen, Faculty of Medicine, Albert Ludwigs University Freiburg, Freiburg, Germany

2. Policlinico S.Orsola-Malpighi, Bologna, Italy

3. Dupuytren University Hospital, Limoges, France

4. Golden Jubilee National Hospital, University of Glasgow, Glasgow, UK

5. Cardioangiologic Center Bethanien, Frankfurt, Germany

6. Hospital Val D’Hebron, Barcelona, Spain

7. Heart Center Hietzing, Vienna, Austria

8. Department of Advanced Biomedical Sciences, University of Napoli “Federico II”, Naples, Italy

9. Department of Cardiac Surgery, Rzeszów, Poland

10. Department of Cardiac, Thoracic and Vascular Surgery, University of Tübingen, Tübingen, Germany

11. Department of Cardiology, Humanitas Gavazzeni, Bergamo, Italy

12. Cardiovascular Surgery, University of Brescia, Brescia, Italy

13. Department of Cardiology, Royal Brompton Hospital, London, UK

14. Department of Cardiac Surgery, European Hospital, Rome, Italy

15. West German Heart Center, Essen, Germany

Abstract

Abstract Since its clinical implementation in the late nineties, thoracic endovascular aortic repair (TEVAR) has become the standard treatment of several acute and chronic diseases of the thoracic aorta. While TEVAR has been embraced by many, this disruptive technology has also stimulated the continuing evolution of open surgery, which became even more important as late TEVAR failures do need open surgical correction justifying the need to unite both treatment options under one umbrella. This fact shows the importance of—in analogy to the heart team—aortic centre formation and centralization of care, which stimulates continuing development and improves outcome . The next frontier to be explored is the most proximal component of the aorta—the aortic root, in particular in acute type A aortic dissection—which remains the main challenge for the years to come. The aim of this document is to provide the reader with a synopsis of current evidence regarding the use or non-use of TEVAR in acute and chronic thoracic aortic disease, to share latest recommendations for a modified terminology and for reporting standards and finally to provide a glimpse into future developments.

Publisher

Oxford University Press (OUP)

Subject

Cardiology and Cardiovascular Medicine,Pulmonary and Respiratory Medicine,General Medicine,Surgery

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