Features of aortic anatomy in patients with proximal thoracic aortic aneurysmal disease.

BACKGROUND

Despite growing interest in studying the anatomical characteristics of the thoracic aorta, the current evidence base remains insufficient.

OBJECTIVE

To analyze the features of anatomy of the thoracic aorta and its branches in patients with aneurysmal pathology of the aortic root and ascending aorta.

PATIENTS AND

METHODS

This retrospective study included 81 patients with aneurysmal pathology of the proximal thoracic aorta. They were divided into two groups based on the extent of the pathological process: an ascending aortic aneurysm with a normal aortic root (AAA, n=47) and a tubular ascending aortic aneurysm with root involvement (AAAR, n=34). A comparative analysis of the anatomical features of the aorta and its branches was conducted.

RESULTS

Patients with isolated ascending aortic aneurysms were statistically significantly more likely to have bicuspid aortic valve disease (p=0.043) and aortic valve stenosis (p=0.005). The aortic valve annulus size was statistically significantly larger in patients with a combined root and ascending aortic aneurysm (p=0.002), as were the thoracic aortic diameters at all analyzed levels. There were no statistically significant differences in thoracic aortic length between groups. Patients with local ascending aortic aneurysms were more likely to have aortic arch vascular anomalies than those with root and ascending aortic aneurysms.

CONCLUSION

Patients with both isolated tubulars ascending aortic aneurysms and ascending and root aortic aneurysms had comparable aortic status. At the same time, there are a number of important intergroup differences, which suggests the need to consider these patients from the perspective of different variants of the same pathology, especially when implementing a personalized approach to the diagnosis and monitoring of these patients.