Key result
The pre-dissection ratio between descending and ascending aorta diameters was significantly smaller in patients with acute type A aortic dissection compared to reference values (MD -0.088; P<0.001).
Why the study?
A novel surrogate marker is needed to guide clinical decision making for ascending aortic dilatation.
Does the ratio between descending and ascending aorta diameters help stratify the risk of acute type A aortic dissection?
Cohort (n=50)
No
Does the ratio between descending and ascending aorta diameters help stratify the risk of acute type A aortic dissection?
The 55 mm threshold for ascending aorta diameter may be insufficient for assessing dissection risk, and the ratio between descending and ascending aorta diameters could serve as a novel risk stratification tool.
May support ratio-based stratification for type A dissection risk; leaves open whether it improves on diameter thresholds in prospective studies.
(1) Background: There is a need for a novel surrogate marker to ease decision making when facing ascending aortic dilatation. In this article, we study the ratio between ascending and descending aorta diameters as a potential one. (2) Methods: Retrospective observational cohort study, including all the patients who underwent surgery for acute type A aorta dissection (aTAAD) between January 2014 and September 2020 at our center. A total of 50 patients were included. Clinical and demographic data were collected. The anatomical measurements were made including orthogonal maximal diameters of the ascending and descending aorta, post-dissection whole circumference length (post-wCL), post-dissection true lumen circumference length (post-tCL), and surface and sphericity indices of the ascending and descending aorta. Pre-dissection ascending aorta diameter (pre-AAD) and pre-dissection descending aorta diameter (pre-DAD) were calculated as well as the ratio between them and compared with reference values. (3) Results: Of the pre-AAD patients, 96% had smaller than the recommended 55 mm. The ratio between the descending and ascending aorta pre-dissection diameters was significantly smaller compared to the reference value (0.657 ± 0.125 versus 0.745 ± 0.016 with a mean difference of −0.088 and a p < 0.001). (4) Conclusions: The 55 mm threshold for aorta maximal diameter is an insufficient criterion when assessing the risk of dissection. The ratio between DAD and AAD is a parameter worthy of analysis as a tool to stratify the risk of dissection.
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Perez et al. (2023) conducted a cohort in Acute type A aorta dissection (aTAAD) (n=50). Ratio between descending and ascending aorta pre-dissection diameters vs. Reference values was evaluated on Ratio between descending and ascending aorta pre-dissection diameters (MD -0.088, p=<0.001). The pre-dissection ratio between descending and ascending aorta diameters was significantly smaller in patients with acute type A aortic dissection compared to reference values (MD -0.088; P<0.001).
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