Trial of Exercise in Aortic Dissection Survivors

The primary objective of this study is to test the safety and mental health benefits of a guided exercise program for people who survived an acute aortic dissection. This study is designed to answer several questions:Can supervised exercise improve confidence and mental health in dissection survivors?;How safe are different types of exercise for people who are living with severe aortic disease?;Can tests be developed to determine rational and safe limits to guide exercise recommendations for individual patients?;Does the blood pressure response to exercise predict risks for aortic enlargement or dissection in unique ways that other tests may not detect?The long-term goal of this research is to develop new guidelines for exercise and daily activities that promote the safety and well-being of all TAD patients.All participants will be required to:Complete online questionnaires (demographic survey, 2009 Behavioral Risk Factor Surveillance Survey, the Patient-Reported Outcomes Measurement Information System 29 (PROMIS-29) v2.0 profile questionnaire)Exercise (>150 minutes/week)Receive all usual clinically indicated care, including diagnostic tests and medications. Recommendations for tests or interventions will not change based on the assigned study arm.Participants who are randomized to guided exercise group will undergo initial training that consists of: one video demonstration, one exercise training session or group session, one follow up home visit, and virtual check-ins.Participants who are randomized to usual care will attend routine clinic visits but will not receive any teaching or supervision and will not participate in any in-person or virtual exercise sessions. Instead, they will receive standardized counseling about exercise, including an exercise pamphlet that is given to all TAD patients.

Inclusion Criteria:-Patients who survived a thoracic aortic dissection (Type A or B) at least 3 months prior to study.Exclusion Criteria:Routine participation in > 150 minutes per week of moderate intensity exercisesUnable to attend at least one exercise training session in personUncontrolled hypertension: mean SBP > 160 mmHg at restSymptomatic aortic, coronary, or vascular diseaseUnable to complete exercise circuit due to physical limitations, equipment, space, or time commitmentDo not own a treadmill or stationary cycle or have regular access to one at a gym.