Imaging of Genetic Thoracic Aortopathy

Kacie L Steinbrecher1, Kaitlin M Marquis1, Alan C Braverman1

  • 1From the Mallinckrodt Institute of Radiology (K.L.S., K.M.M., S.B., C.A.R.), Department of Internal Medicine, Cardiovascular Division (A.C.B.), Department of Surgery (J.W.O.), and Department of Pathology (C.Y.L.), Washington University School of Medicine, 510 S Kingshighway Blvd, St Louis, MO 63110; and Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Ga (M.N.).

Insights

Genetic aortopathy increases the risk of aortic events. Early identification by radiologists is crucial for timely intervention and tailored surgical repair in patients with heritable thoracic aortic disease (HTAD).

Area of Science:

  • Genetics and Radiology
  • Cardiovascular Imaging
  • Thoracic Aortic Disease

Background:

  • Aortopathy encompasses genetic diseases leading to increased risk of aortic events like aneurysm and acute aortic syndrome.
  • Heritable thoracic aortic disease (HTAD) is subclassified into syndromic and nonsyndromic forms, with syndromic HTAD presenting specific phenotypic features.
  • Radiologists are often the first to detect signs of genetic aortopathy, necessitating awareness of its implications.

Purpose of the Study:

  • To highlight the importance of radiologist recognition of genetic aortopathy.
  • To emphasize the distinct management and surgical intervention thresholds for genetic aortopathy compared to non-genetic forms.
  • To underscore the need for familiarity with differential diagnoses, including acquired thoracic aortic diseases.

Main Methods:

  • Review of imaging and phenotypic features associated with various types of genetic aortopathy.
  • Comparison of diagnostic challenges and management strategies for genetic versus non-genetic aortopathy.
  • Emphasis on a multidisciplinary approach integrating imaging for diagnosis and lifelong follow-up.

Main Results:

  • Genetic aortopathy requires lower aortic diameter thresholds for surgical intervention.
  • Surgical approaches and extent may differ in patients with genetic aortopathy.
  • Overlapping imaging and phenotypic features can complicate diagnosis and follow-up recommendations.

Conclusions:

  • Radiologists play a critical role in the early identification of genetic aortopathy.
  • Accurate diagnosis and understanding of genetic aortopathy are essential for appropriate clinical management and surgical planning.
  • Lifelong imaging surveillance is crucial for patients diagnosed with genetic aortopathy.

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