ABSTRACT
Background: Little information is available regarding the
relationship between ascending aortic length and acute aortic events. We
aim to evaluate whether patients with acute type A aortic dissection
(ATAAD) exhibit differential aortic measurements compared to control
patients.
Methods: Data were collected on patients with ATAAD and control
patients who received imaging for unrelated conditions. Propensity score
matching was conducted using age, sex, race, body surface area, and
hypertension in the logistic model. After matching, 67 patients remained
in each group. Aortic morphometry was assessed via computed tomographic
angiography. Ascending aortic length was defined as the centerline
distance between the sinotubular junction (STJ) and the origin of the
brachiocephalic trunk.
Results: The mean ascending aortic length was 76.9 ± 15.7 mm
(range 36.8 to 115.0 mm) for patients with ATAAD and was 62.0 ± 10.7 mm
(range 34.0 to 87.8 mm) for control patients, which was a significant
difference (t=-6.4, P<0.001). ATAAD patients had greater
diameter at STJ (median: 41.6 vs 30.2 mm, z=7.5, P<0.001) and
diameter at PAB (median: 42.3 vs 32.2 mm, z=6.8, P<0.001)
compared with controls. A maximum ascending aortic diameter
>5.5 cm (at either the PAB or STJ) was present in 12 of 67
cases (18%) and 0 of 67 controls (P<0.001).
Conclusions: Ascending aortic length is significantly greater
in patients who experienced ATAAD compared to matched controls.
Elongation of the aorta may play a role in the pathogenesis of ATAAD,
and assessment of ascending aortic length may be valuable as a
predictive marker for aortic events.
Keywords: Aorta, Ascending, Dissection, Anatomy