Aortic elongation part II: the risk of acute type A aortic dissection

Aortic elongation part II: the risk of acute type A aortic dissection

- in HEALTH
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Targets

Prophylactic surgical procedure for prevention of acute kind A aortic dissection (ATAAD) is reserved for sufferers with an ascending aortic aneurysm ≥55 mm. Identification of further threat predictors is warranted since over 70% of sufferers presenting with ATAAD have a non-dilated aorta or an aneurysm that may not have met the diameter criterion for preventative surgical procedure. Intention of the research was to guage ascending aortic elongation as a threat issue for ATAAD and to check aortic lengths between ATAAD sufferers and wholesome controls.

Strategies

Aortic lengths and diameters of ATAAD sufferers had been measured on three-dimensional modelled computed tomography and adjusted to predissection dimensions on this cross-sectional single-centre research. Logistic regression was used to guage the relation between ATAAD and aortic dimensions. Lengths of various aortic segments had been in contrast with a wholesome management group utilizing propensity rating matching.

Outcomes

Two-hundred and fifty sufferers had been included within the research (ATAAD, n=40; controls, n=210). Ascending aortic size and diameter proved to be unbiased predictors for ATAAD (OR=5.three, CI 2.5 to 11.four, p<zero.001 and OR=eight.6, CI 2.four to 31.zero, p=zero.001). Eighty sufferers had been matched based mostly on propensity scores (ATAAD n=40, controls n=40). The ascending aorta was longer and extra dilated in ATAAD sufferers in contrast with wholesome controls (78.6±eight.eight mm vs 68.9±7.2 mm, p<zero.001, 34.four mm ±three.2. vs 39.four mm ±5.7, p<zero.001, respectively). No variations had been present in lengths of the aortic arch and descending aorta.

Conclusions

Ascending aortic size might function an unbiased predictor for ATAAD. Future research addressing indications for prophylactic surgical procedure must also examine aortic size.

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