The Society of Thoracic Surgeons/American Association for Thoracic Surgery clinical practice guidelines on the management of type B aortic dissection

The Society of Thoracic Surgeons (STS) and the American Association for Thoracic Surgery (AATS) today published this clinical practice guidelines on the management of type B aortic dissection. Class I recommendations are:

Use of a stepwise approach to the evaluation and treatment of patients with TBAD, followed by close clinical surveillance;

Optimal medical therapy (OMT) remains the recommended treatment for patients with uncomplicated TBAD;

TEVAR is indicated for complicated hyperacute, acute, or subacute TBADs and favorable anatomy for TEVAR;

Open repair is preferred over TEVAR as a more durable treatment in patients with connective tissue disorders who have TBAD with progression of disease despite OMT;

Revascularization of the left subclavian artery (LSA) is recommended to decrease the risk of spinal cord ischemia (SCI) if TEVAR coverage obstructs antegrade LSA flow.