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CC BY 4.0 · Aorta (Stamford) 2020; 08(05): 132-140
DOI: 10.1055/s-0040-1715609
Original Research Article

Aortic Thickness: A Forgotten Paradigm in Risk Stratification of Aortic Disease

Ashutosh Hardikar
1   Menzies Institute for Medical Research, University of Tasmania, Australia
2   Department of Cardiothoracic Surgery, Royal Hobart Hospital, Hobart, Australia
,
Robin Harle
3   Department of Radiology, Royal Hobart Hospital, Hobart, Australia
,
Thomas H. Marwick
1   Menzies Institute for Medical Research, University of Tasmania, Australia
4   Baker Heart and Diabetes Institute, Melbourne, Australia
› Institutsangaben
Funding None.
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Abstract

Background This study aimed at risk-stratifying aortic dilatation using aortic wall thickness (AWT) and comparing methods of AWT assessment.

Methods Demographic, epidemiological, and perioperative data on 72 consecutive aortic surgeries (age = 62 years[standard deviation (SD) = 12] years) performed by a single surgeon were collected from hospital database. Aortic thickness was measured on computed tomography scans, as well as intraoperatively in four quadrants, at the level of aortic sinuses, as well as midascending aorta, using calipers. Aortic wall stress was calculated using standard mathematical formulae.

Results The ascending aorta was 48.2 (SD = 8) mm and the mean thickness at ascending aorta level was 1.9 (SD = 0.3) mm. There was congruence between imaging and intraoperative measurements of thickness, as well as between the radiologist and surgeon. Preoperatively, 16 patients had multiple imaging studies showing an average rate of growth of 1.2 mm per year without significant difference in thickness. The wider the aorta, the thinner was the lateral or convex wall. Aortic stenosis (p = 0.01), lateral to medial wall thickness ratio (p = 0.04), and history of hypertension (p = 0.00), all had protective effect on aortic root stress. The ascending aortic stress was directly affected by age (p = 0.03) and inversely related to lateral to medial wall thickness ratio (p = 0.03).

Conclusion Aortic thickness can be measured preoperatively and easily confirmed intraoperatively. Risk stratification based on both aortic thickness and diameter (stress calculations) would better predict acute aortic events in dilated aortas and define aortic resection criteria more objectively.

Keywords

aortic wall thickness - aortic dilatation - aortopathy - aortic stress


Publikationsverlauf

Eingereicht: 15. Juli 2019

Angenommen: 20. Juni 2020

Artikel online veröffentlicht:
23. Dezember 2020

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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