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Ascending Aortic Length and Its Association With Type A Aortic Dissection

Daniella Eliathamby1, Mariana Gutierrez1, Aileen Liu1

  • 1Division of Cardiovascular Surgery University Health Network Toronto Canada.

Journal of the American Heart Association
|June 14, 2021
PubMed

Insights

Ascending aortic length, adjusted for diameter, age, and sex, is longer in patients with type A aortic dissection compared to controls. This finding may help differentiate dissection patients from those with normal aortas or thoracic aneurysms.

Area of Science:

  • Cardiovascular Imaging and Diagnostics
  • Thoracic Surgery and Aortic Disease

Background:

  • Type A aortic dissection is a life-threatening condition involving the ascending aorta.
  • Understanding morphological differences in the aorta can aid in diagnosis and risk stratification.
  • The role of ascending aortic dimensions, specifically length, in type A dissection is not fully elucidated.

Purpose of the Study:

  • To investigate the association between ascending aortic length and diameter and type A aortic dissection.
  • To determine if aortic dimensions can differentiate patients with type A dissection from controls and aneurysm patients.

Main Methods:

  • Computed tomography (CT) scans of patients with acute type A dissection (n=51), thoracic aortic aneurysms (n=121), and controls (n=200) were analyzed.
  • Multiplanar reconstruction was used to measure ascending aortic length and diameter from the aortic annulus to the innominate artery.
  • Predissection aortic dimensions were estimated for dissection patients based on established models.

Main Results:

  • Ascending aortic length was significantly longer in dissection patients (median 109.7 mm), estimated predissection patients (median 104.2 mm), and aneurysm patients (median 107.0 mm) compared to controls (median 83.2 mm).
  • Ascending aortic diameter was largest in the aneurysm group (median 52.0 mm), followed by the dissection group (median 50.3 mm).
  • After adjustment for diameter, age, and sex, estimated predissection aortic lengths were 16 mm longer than controls and 12 mm longer than in patients with nondissected thoracic aneurysms.

Conclusions:

  • Ascending aortic length, when adjusted for key patient and aortic parameters, appears to be a valuable metric.
  • This metric may aid in distinguishing patients with type A aortic dissection from individuals with normal aortas or thoracic aneurysms.
  • Further research into aortic morphometry could enhance diagnostic capabilities for aortic pathologies.

Keywords:
aortic dissectioncardiovascular surgerycomputed tomographyepidemiologyimaging

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