Dynamic Changes in the Aorta During the Cardiac Cycle Analyzed by ECG-Gated Computed Tomography

Area of Science:

• Cardiovascular Imaging
• Medical Device Engineering
• Aortic Anatomy

Background:

• Aortic dimensions fluctuate significantly throughout the cardiac cycle.
• Electrocardiogram (ECG)-gated computed tomography angiography (CTA) is used to assess these changes.
• Accurate aortic sizing is crucial for effective stent selection.

Purpose of the Study:

• To characterize aortic dimensional changes during the cardiac cycle using ECG-gated CTA.
• To evaluate if parameters other than diameter offer a more reliable reference for stent selection.
• To focus on the aortic arch and proximal thoracic descending aorta.

Main Methods:

• Reviewed CTA imaging from 90 patients during the cardiac cycle.
• Analyzed three specific locations in the aorta (innominate, left common carotid, left subclavian artery origins).
• Measured maximum diameter, minimum diameter, lumen area, lumen perimeter, and diameter derived from lumen area.

Main Results:

• Significant differences in aortic dimensions were observed during the cardiac cycle (p < 0.001).
• The diameter derived from lumen area exhibited the least change over time compared to other parameters (p < 0.01).
• This stability was consistent across all three analyzed aortic locations.

Conclusions:

• Aortic dimensional variations during the cardiac cycle are clinically significant.
• Diameter derived from lumen area may be a superior metric for stent sizing in the aortic arch and proximal thoracic aorta.
• Further prospective studies are needed to confirm clinical outcomes associated with this measurement parameter.