Association between the ascending aortic length and sporadic type A aortic dissection

This study was performed to outline the aortic dimensions of type A aortic dissection and to investigate the association between the ascending aortic length and sporadic, non-syndromic type A aortic dissection in a Chinese population.

In this cross-sectional study, all consecutive patients diagnosed with type A aortic dissection between January 2016 and December 2020 were identified. Parameters were measured based on the centerline method. The predissection aortic diameter and length were calculated. Multivariate logistic regression models were used to assess the association between the ascending aortic length and type A aortic dissection. A receiver operating characteristic analysis was performed to calculate the area under the curve and optimal cutoff value.

A total of 146 patients and 146 propensity score-matched controls were included in the study. The median length of the ascending aorta was 21 mm longer in the patient group than in the control group (median, 110.0 mm vs. 89.0 mm), and was still 15.4 mm longer after adjusting for the predissection length (median, 104.4 mm). The ascending aortic length was independently associated with type A aortic dissection (odds ratio, 5.34; 95% confidence interval, 3.59-7.92). The ascending aortic length revealed a larger area under the curve, and an optimal cutoff value of 9.8 cm was revealed.

The ascending aortic length (AAL) appears to be associated with type A aortic dissection (TAAD) and may complement the aortic diameter in morphologic risk assessment, but additional prospective studies with standardized measurements and body-size adjustment are required before clinical thresholds can be established. Observed AAL values associated with TAAD were lower in this Chinese cohort than in the Western population.