Original article: cardiovascularYearly rupture or dissection rates for thoracic aortic aneurysms: simple prediction based on size
Section snippets
Patient population
Our database now includes information on 721 patients with TAAs. There are 2,276 total patient-years of follow-up and 1,383 patient-years of follow-up preceding operation, from which natural history can be assessed. We have analyzed 3,115 radiographic studies (985 computed tomographic scans, 418 magnetic resonance imaging scans, 139 transesophageal echocardiography studies, 1,344 transthoracic echocardiography studies, and 229 angiographic studies) of patients with thoracic aortic disease.
Aneurysm characteristics
The distribution of aneurysms by initial size is shown in Table 1. Aneurysms of the ascending aorta were substantially more common than the others. The mean initial aortic size for patients with Marfan syndrome was significantly smaller than for those without (4.6 versus 5.1 cm, p = 0.0001); in addition, aneurysms of the aortic arch and thoracoabdominal aorta were significantly larger than those of the ascending aorta (5.9 and 5.7 versus 4.8 cm, p < 0.005).
Aneurysm growth rates
Aneurysm growth rates were calculated
Comment
Examining the natural history of TAAs is complicated by a number of issues specific to the disease, which make scientific assessments of risks difficult. Patients with large aneurysms or high rates of growth between imaging studies and those with significant symptoms are usually selected for surgical intervention. Those who are not selected for operation may have been excluded as surgical candidates because of significant comorbidities. Therefore, studies of risk factors for complications
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