Abstract
Background:
We aimed to evaluate size changes of the thoracic aorta during the cardiac cycle
with dynamic computed tomographic angiography (CTA) at specific anatomic landmarks
in patients who previously underwent ascending aorta repair because of type A dissection,
and to correlate aortic wall motion with several cardiovascular risk factors.
Methods:
From December 2008 to December 2010, 18 patients (14 men and 4 women, mean age 64
± 12 years) with previous aortic repair underwent electrocardiography-gated CTA follow-up.
Aortic systolic and diastolic diameter and cross-sectional area were measured at 4
levels: 1 cm proximal (level A) and 1 (B), 3 (C), and 10 cm (D) distal to the origin
of the left subclavian artery. Results were assessed according to age and presence
of diabetes, hypertension, and smoking.
Results:
This morpho-functional evaluation of aortic wall motion demonstrated a significant
influence (P < 0.05) of hypertension at level A and D and diabetes at level D. Smoking had a borderline
significance at level C and D. No significant correlation with age was evident, with
results not significantly different in patients ≤ 55 and > 55 years.
Conclusions:
Smoking, diabetes, and hypertension play a role in impairing aortic size variations.
These variations might predict wall structural alterations due to cardiovascular risk
factors before they become morphologically evident. This might influence timing of
surveillance following repair of acute dissection, allowing it to be specifically
tailored for any single subject.
Key Words
Aortic dissection - Repair of aortic dissection - Computed tomography
