High-Volume Hospitals for Patients Affected by Thoracic Aortic Diseases. Do We Really Need them?

The term “thoracic aortic disease” (TAD) includes a wide range of aortic diseases with variable clinical presentations and prognosis. The Global Burden Disease 2010 project demonstrated that the overall global death rate from aortic aneurysms and aortic dissection increased from 2.49 per 100000 to 2.78 per100000 inhabitants between 1990 and 2010, with higher rates for men. 

At the same time, admissions for thoracic aortic aneurysms have increased from 4.4 to 9.0 per 100000 in the UK, mainly due to an increase in elderly patients, over 75 years of age. Despite this emerging epidemic, standard of care for TAD has not been established. The 2010 American Heart Association (AHA) guidelines for the management of TAD include a level I recommendation for the “evidence-based referral” of TAD patients, limiting their care to large volume centres, with experienced physicians, and supporting teams.            Read more>>>>>>>