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Yearly rupture or dissection rates for thoracic aortic aneurysms: simple prediction based on size
Ryan R Davies1, Lee J Goldstein, Michael A Coady
1Section of Cardiothoracic Surgery and School of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Connecticut 06510, USA.
The Annals of Thoracic Surgery
|February 9, 2002
Summary
Thoracic aortic aneurysms are lethal, with size significantly predicting rupture or dissection risk. Elective surgical repair can restore normal life expectancy for patients with large aneurysms.
Area of Science:
- Cardiovascular Surgery
- Aortic Disease Research
- Medical Imaging Analysis
Background:
- Prior research established lifetime risks for thoracic aneurysm rupture based on size.
- Estimating yearly rupture/dissection rates is crucial for patient-specific clinical decisions.
- Robust data is essential for accurate rate calculation.
Purpose of the Study:
- To determine the yearly rate of rupture or dissection for thoracic aortic aneurysms.
- To establish the impact of aneurysm size on rupture, dissection, and mortality.
- To evaluate the effectiveness of elective surgical repair in improving survival.
Main Methods:
- Prospective data collection on 721 patients with thoracic aortic disease over 9 years.
- Survival analysis of 570 patients meeting inclusion criteria for follow-up.
- Exclusion of patients who underwent surgery to analyze natural history.
Main Results:
- Aneurysm size is a strong predictor of rupture, dissection, and mortality.
- For aneurysms >6 cm, yearly rates include: 3.7% rupture, 6.9% rupture/dissection, 11.8% death.
- Aorta growth averaged 0.10 cm/year; >6 cm aneurysms had a 27-fold increased rupture odds.
Conclusions:
- Thoracic aneurysm is a lethal condition significantly influenced by size.
- Patients with aneurysms >6 cm face yearly rupture/dissection rates of at least 6.9% and death rates of 11.8%.
- Elective surgical repair normalizes survival, supporting proactive intervention and monitoring.