Aortic Diameter ≥5.5 cm Is Not a Good Predictor of Type A Aortic Dissection
Top Cited Papers
- 4 September 2007
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Circulation
- Vol. 116 (10), 1120-1127
- https://doi.org/10.1161/circulationaha.107.702720
Abstract
Background— Studies of aortic aneurysm patients have shown that the risk of rupture increases with aortic size. However, few studies of acute aortic dissection patients and aortic size exist. We used data from our registry of acute aortic dissection patients to better understand the relationship between aortic diameter and type A dissection. Methods and Results— We examined 591 type A dissection patients enrolled in the International Registry of Acute Aortic Dissection between 1996 and 2005 (mean age, 60.8 years). Maximum aortic diameters averaged 5.3 cm; 349 (59%) patients had aortic diameters P =0.04), radiating pain (odds ratio, 2.08; 95% confidence interval, 1.08 to 4.0; P =0.03), and increasing age (odds ratio, 1.03; 95% confidence interval, 1.00 to 1.05; P =0.03). Marfan syndrome patients were more likely to dissect at larger diameters (odds ratio, 14.3; 95% confidence interval, 2.7 to 100; P =0.002). Mortality (27% of patients) was not related to aortic size. Conclusions— The majority of patients with acute type A acute aortic dissection present with aortic diameters <5.5 cm and thus do not fall within current guidelines for elective aneurysm surgery. Methods other than size measurement of the ascending aorta are needed to identify patients at risk for dissection.This publication has 27 references indexed in Scilit:
- Limited role of aortic size in the genesis of acute type A aortic dissectionEuropean Journal of Cardio-Thoracic Surgery, 2005
- Aortic Root Growth in Men and Women With the Marfan’s SyndromeThe American Journal of Cardiology, 2005
- Contemporary results of surgery in acute type A aortic dissection: The International Registry of Acute Aortic Dissection experienceThe Journal of Thoracic and Cardiovascular Surgery, 2005
- Should the ascending aorta be replaced more frequently in patients with bicuspid aortic valve disease?The Journal of Thoracic and Cardiovascular Surgery, 2004
- Role of Aortic Root Motion in the Pathogenesis of Aortic DissectionCirculation, 2004
- Mapping a Locus for Familial Thoracic Aortic Aneurysms and Dissections ( TAAD2 ) to 3p24–25Circulation, 2003
- Replacement of the Aortic Root in Patients with Marfan's SyndromeThe New England Journal of Medicine, 1999
- Reduced penetrance and variable expressivity of familial thoracic aortic aneurysms/dissectionsThe American Journal of Cardiology, 1998
- Hemodynamic considerations regarding the mechanism and prevention of aortic dissectionThe Annals of Thoracic Surgery, 1994
- DISSECTING ANEURYSM OF THE AORTAMedicine, 1958