Ray HM et al. – In the current study, authors investigated the effect of maximum ascending aortic diameter and area in patients with uncomplicated acute type B aortic dissection (uATBAD). The authors concluded that patients with uATBAD with ascending aortic area >12.1 cm2 are at a high risk of developing subsequent arch or proximal progression and may require closer follow–up or earlier intervention. Thus, ascending aortic size (diameter and area) is predictive of reduced intervention–free survival in patients with uATBAD.

Methods

• A total of 304 patients admitted with uATBAD were reviewed and those with available imaging (245 with non–contrast computed tomography and 131 having computed tomography angiography) were included.

Results

• Patients with ascending aortic area >12.1 cm2 were highly associated with subsequent arch or proximal progression and predicted reduced intervention–free survival.
• Maximum aortic diameter along the length of the aorta >44 mm continued to be a risk factor for mortality when diabetes, age, history of stroke, syncope on admission, and ascending diameter >40.8 mm were adjusted.
• Although maximum ascending aortic diameter failed to predict overall survival when >40.8 mm and <40.8 mm groups were compared, maximum aortic diameter along the length of the aorta >44 mm held true as demonstrated earlier.
• Maximum aortic diameter along the length of the aorta >44 mm continued to be a risk factor for reduced intervention–free survival, syncope on admission, pleural effusion on admission, and ascending diameter >40.8 mm.