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Predictors of Stable Aortic Dimensions in Medically Managed Acute Aortic Syndromes
Arnoud V Kamman1, Frederik H W Jonker2, Udo Sechtem3
1Department of Vascular Surgery, Policlinico San Donato IRCCS, University of Milan, San Donato Milanese, Italy; Department of Medicine, Frankel Cardiovascular Center, University of Michigan, Ann Arbor, MI; Department of Cardiac Surgery, Frankel Cardiovascular Center, University of Michigan, Ann Arbor, MI; Department of Vascular Surgery, University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands.
Complete false lumen thrombosis predicts stable aortic dimensions in medically managed type B aortic dissections (TBAD). Female gender and larger sinotubular junction predict aortic growth, aiding in predicting patient outcomes.
Area of Science:
- Cardiovascular Research
- Aortic Disease Management
- Medical Imaging Analysis
Background:
- Medically managed type B aortic dissections (TBAD) require identification of predictors for stable aortic dimensions.
- Understanding TBAD progression is crucial for optimizing patient management and follow-up strategies.
Purpose of the Study:
- To identify predictors of stable aortic dimensions in patients with medically managed type B aortic dissections (TBAD).
- To differentiate between patients with and without aortic growth over a 24-month period.
Main Methods:
- Retrospective analysis of 219 medically managed TBAD patients from the International Registry of Acute Aortic Dissection.
- Calculation of aortic growth rate based on changes in descending aortic diameter over up to 24 months.
- Stratification into groups with and without aortic growth (<0.0 mm/year vs. >0.0 mm/year).
Main Results:
- 59.4% of patients exhibited aortic growth, with a mean expansion rate of 0.19 ± 0.81 cm.
- Complete false lumen thrombosis was associated with no aortic growth (HR: 3.640, P=0.011).
- Larger sinotubular junction (STJ) (HR: 0.304, P=0.004) and female gender (HR: 0.325, P=0.030) predicted aortic growth.
Conclusions:
- Complete false lumen thrombosis is a key predictor of stable aortic dimensions in medically managed TBAD.
- A large STJ and female gender are associated with increased aortic growth in TBAD patients.
- These findings can help predict the clinical course of medically treated TBAD patients during follow-up.