Abstract
Background The aim of this study was to determine the role of ascending aortic length and diameter in type A aortic dissection. Methods and Results Computed tomography scans from patients with acute type A dissections (n=51), patients with proximal thoracic aortic aneurysms (n=121), and controls with normal aortas (n=200) were analyzed from aortic annulus to the innominate artery using multiplanar reconstruction. In the control group, ascending aortic length correlated with diameter (r2=0.35, P<0.001), age (r2=0.17, P<0.001), and sex (P<0.001). As a result of immediate changes in aortic morphology at the time of acute dissection, predissection lengths and diameters were estimated based on models from published literature. Ascending aortic length was longer in patients immediately following acute dissection (median, 109.7 mm; interquartile range [IQR], 101.0-115.1 mm), patients in the estimated predissection group (median, 104.2 mm; IQR, 96.0-109.3 mm), and patients in the aneurysm group (median, 107.0 mm; IQR, 99.6-118.7 mm) in comparison to controls (median, 83.2 mm; IQR, 74.5-90.7 mm) (P<0.001 all comparisons). The diameter of the ascending aorta was largest in the aneurysm group (median, 52.0 mm; IQR, 45.9-58.0 mm), followed...Continue Reading
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