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Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
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Novel and Innovative Hybrid Technique for Type A Aortic Dissection
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An Emergent Nexus between Striae and Thoracic Aortic Dissection.

Benjamin J Landis1,2, Courtney E Vujakovich1, Lindsey R Elmore1

  • 1Riley Hospital for Children Heart Center, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN 46202, USA.

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|January 21, 2022
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Summary

Skin striae, a connective tissue abnormality, are linked to thoracic aortic aneurysm (TAA) and aortic dissection (TAD) in adults. This finding may improve risk stratification for aortopathy severity.

Keywords:
Marfan syndromeconnective tissuesstriaethoracic aortic aneurysmthoracic aortic dissection

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Area of Science:

  • Cardiovascular Medicine
  • Genetics
  • Dermatology

Background:

  • Current thoracic aortic aneurysm (TAA) risk stratification lacks precision, impacting clinical decisions.
  • Previous studies in children suggested a link between skin striae and accelerated aortic dilation.
  • Connective tissue abnormalities are increasingly recognized in aortopathy.

Purpose of the Study:

  • To investigate the association between connective tissue abnormalities and clinical outcomes in adults with aortopathy.
  • To determine if specific connective tissue signs correlate with disease severity or events like aortic dissection.
  • To explore the prevalence of connective tissue dysfunction in adult patients with thoracic aortic disease.

Main Methods:

  • Retrospective analysis of 241 adult participants with TAA or aortic dissection (TAD) and trileaflet aortic valve enrolled between 2016-2019.
  • Data collection via structured interviews to ascertain clinical history and physical findings.
  • Multivariate analysis to identify significant associations between connective tissue abnormalities and clinical endpoints.

Main Results:

  • 47% of participants exhibited connective tissue abnormalities, including abdominal hernia (20%) and atypical skin striae (13%).
  • Skin striae and hypertension were significantly associated with a history of aortic dissection (TAD).
  • Skin striae correlated with younger age at TAD diagnosis or prophylactic aortic surgery.

Conclusions:

  • Systemic connective tissue dysfunction is common in adults with thoracic aortopathy.
  • Skin striae emerge as a potential biomarker for increased aortopathy severity and risk.
  • These findings offer new avenues for clinical risk stratification and basic research into aortopathy.