Aortic Arch Anatomy in Candidates for Aortic Arch Repair

Area of Science:

• Cardiovascular Surgery
• Medical Imaging
• Anatomical Studies

Background:

• Developing novel prostheses for aortic arch repair necessitates detailed anatomical knowledge.
• Previous studies have not comprehensively analyzed aortic arch anatomy in relation to various pathologies.

Purpose of the Study:

• To conduct a thorough analysis of aortic arch anatomy in patients considered for aortic arch repair.
• To identify variations in aortic arch anatomy associated with different aortic pathologies.

Main Methods:

• Computed tomography angiography (CTA) was used to analyze aortic arch anatomy in 558 patients.
• Key measurements included aortic diameters, segmental lengths, arch types, tortuosity, and supraaortic vessel dimensions.
• Patients with thoracic aortic treatment for type A, B, non-A non-B dissection, or aortic arch aneurysm were included.

Main Results:

• Aortic arch type distribution varied by pathology; type III was most common in type B dissection (47%) and aneurysm (52%) patients.
• The ascending aorta and aortic arch were not dilated in type B and non-A non-B dissection patients.
• Specific median diameters and lengths for supraaortic vessels (innominate, left common carotid, left subclavian arteries) were documented.

Conclusions:

• Aortic arch anatomy, specifically arch type, differs across various aortic pathologies.
• Type B and non-A non-B aortic dissections are characterized by a non-dilated ascending aorta and aortic arch.
• Aortic arch tortuosity and supraaortic artery lengths did not significantly differ among the studied aortic pathologies.