[Decision-making in thoracic aorta dilatation. State of the art]

According to recent guidelines, the main criterion for decision-making in aneurysmal thoracic aorta is its diameter. However, it is now well known that not only this parameter is responsible for aortic related events. Many authors confirm the need for searching additional indications for surgical interventions, including anatomical peculiarities revealed by the findings of multislice computed tomography. At present, the primary emphasis is on analyzing peculiarities of diagnosis of and surgical approaches to thoracic aortic aneurysms, with the treatment of thoracic aortic dilatation (40-49 mm) being mainly out of the scope. Thoracic aortic dilatation requires additional investigations aimed to determine whether conservative or surgical management is adequate. To date, a scarce evidence base determines diversity of researchers' opinions on this issue.