Nonsyndromic Thoracic Aortic Aneurysms and Dissections-Is Screening Possible?

Semin Thorac Cardiovasc Surg. 2019;31(4):628-634. doi: 10.1053/j.semtcvs.2019.05.035. Epub 2019 Jun 15.

Abstract

Nonsyndromic thoracic aortic aneurysm and dissection (TAAD) account for 95% of all TAAD cases and comprise a subset in which the lack of obvious clinical signs makes diagnosis a challenge. Despite the potentially fatal natural history, timely diagnosis and prophylactic surgical intervention allow restoration of near-normal life expectancy in TAAD patients, underlining the critical importance of screening tests. To date, more than 30 TAAD disease-causing genes have been identified, and over 30% of nonsyndromic TAAD patients have a genetic mutation in 1 or more of these genes. Whole exome sequencing allows routine genetic testing in a clinical setting by screening for all TAAD-related genes, thus facilitating personalized aortic care. Additionally, increased vigilance upon diagnosis of certain TAAD-related diseases ("guilty associates") and the emergence of modern radiologic and novel serologic screening tests will further bolster efforts to detect undiagnosed asymptomatic nonsyndromic TAAD.

Keywords: Aortic dissection; Genetics; Nonsyndromic aortic disease; Screening; Thoracic aortic aneurysm.

Publication types

  • Review

MeSH terms

  • Aortic Aneurysm, Thoracic / diagnostic imaging
  • Aortic Aneurysm, Thoracic / genetics*
  • Aortic Aneurysm, Thoracic / therapy
  • Aortic Dissection / diagnostic imaging
  • Aortic Dissection / genetics*
  • Aortic Dissection / therapy
  • Exome Sequencing*
  • Genetic Predisposition to Disease
  • Genetic Testing / methods*
  • Heredity
  • Humans
  • Mutation*
  • Pedigree
  • Phenotype
  • Predictive Value of Tests
  • Prognosis
  • Risk Assessment
  • Risk Factors