Screening for thoracic aortic pathology: Clinical practice in a single tertiary center

Area of Science:

• Cardiology
• Radiology
• Medical Imaging

Background:

• Thoracic aortic screening is vital for early detection of aortic dilation.
• Clinical practice varies in tertiary centers regarding imaging modalities.
• Transthoracic echocardiography (TTE) and computed tomography (CT) are commonly used.

Purpose of the Study:

• To evaluate current thoracic aortic screening practices in a tertiary center.
• To compare the diagnostic value of TTE versus CT for aortic dilation.
• To identify additional cardiac and arterial abnormalities detected by each modality.

Main Methods:

• Retrospective analysis of 349 patients (≥15 years) undergoing thoracic aortic screening (2012-2016).
• Comparison of aortic diameters (sinus of Valsalva, ascending aorta) measured by TTE and CT.
• Assessment of TTE sensitivity and specificity for aortic dilation (≥40 mm) using CT as the reference standard.

Main Results:

• 65% of patients received both TTE and CT; 35% received TTE only.
• TTE showed lower sensitivity (57-61%) but high specificity (96-100%) for aortic dilation compared to CT.
• TTE detected cardiac abnormalities in 7% of patients; CT identified peripheral arterial issues in 4%.

Conclusions:

• Combined TTE and CT imaging is common practice.
• TTE has limited sensitivity for detecting thoracic aortic dilation.
• CT imaging is recommended at least once for comprehensive thoracic aortic screening.