Height alone, rather than body surface area, suffices for risk estimation in ascending aortic aneurysm

The Journal of Thoracic and Cardiovascular Surgery

Mohammad A. Zafar¹  Camilo A. Velasquez²  Paris Charilaou³  John A. Rizzo⁴  Yupeng Li⁵  Ayman Saeyeldin⁶ 

[1] Aortic Institute at Yale-New Haven Hospital, Yale University School of Medicine, New Haven, Conn;Department of Cardiac Surgery, University Hospital Munich, Ludwig Maximilian University, Munich, Germany;Department of Cardiovascular Surgery, Beijing Anzhen Hospital of Capital Medical University, Beijing, China;Department of Economics and Department of Preventive Medicine, Stony Brook University, Stony Brook, NY;Department of Political Sciences and Economics, Rowan University, Glassboro, NJ;Department of Vascular Surgery, Yale University School of Medicine, New Haven, Conn

关键词: thoracic aortic aneurysm;    ascending aorta;    natural history;    risk estimation;    aortic rupture;    dissection;    death;    aortic height index;   

DOI  :  10.1016/j.jtcvs.2017.10.140

学科分类：心脏病和心血管学

来源: Mosby, Inc.

【 摘 要 】

BackgroundIn international guidelines, risk estimation for thoracic ascending aortic aneurysm (TAAA) is based on aortic diameter. We previously introduced the aortic size index (ASI), defined as aortic size/body surface area (BSA), as a predictor of aortic dissection, rupture, and death. However, weight might not contribute substantially to aortic size and growth. We seek to evaluate the height-based aortic height index (AHI) versus ASI for risk estimation and revisit our natural history calculations.MethodsAortic diameters and long-term complications of 780 patients with TAAA were analyzed. Growth rate estimates, yearly complication rates, and survival were assessed. Risk stratification was performed using regression models. The predictive value of AHI and ASI was compared.ResultsPatients were stratified into 4 categories of yearly risk of complications based on their ASI and AHI. ASIs (cm/m2) of ≤2.05, 2.08 to 2.95, 3.00 to 3.95 and ≥4, and AHIs (cm/m) of ≤2.43, 2.44 to 3.17, 3.21 to 4.06, and ≥4.1 were associated with a 4%, 7%, 12%, and 18% average yearly risk of complications, respectively. Five-year complication-free survival was progressively worse with increasing ASI and AHI. Both ASI and AHI were shown to be significant predictors of complications (P P ConclusionsCompared with indices including weight, the simpler height-based ratio (excluding weight and BSA calculations) yields satisfactory results for evaluating the risk of natural complications in patients with TAAA.

【 授权许可】

Unknown