Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Department of Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong, China.
Echocardiography. 2021 Apr;38(4):531-539. doi: 10.1111/echo.14980. Epub 2021 Feb 2.
This study was designed to review the ascending aortic diameter of patients undergoing surgery for AAD in China and its influence on prognosis.
In the period between January 2018 and January 2020, 265 patients eligible for analysis of ascending aorta were included in this study. The maximum diameter of the ascending aorta was assessed using preoperative computed tomography (CT) scan for patients.
The mean diameter of the ascending aorta of the reference population was 48.16 ± 9.37 mm, and the percentage of subjects with an aorta <55 mm was 80.38%. In this study, we found that BMI, hypertension, and bicuspid aortic valve are the main factors affecting the widening of the ascending aorta, and the diameter of the ascending aorta in patients with AAD is negatively correlated with the patient's long-term prognosis. However, there is no significant difference in survival rates among patients with different ascending aortic diameter.
Ascending aortas with smaller diameter are also prone to dissection, most of which occur at a lower surgical threshold than recommended by current guidelines. Therefore, the diameter of ascending aorta cannot be used as an independent risk factor for high-risk patients with aortic dissection, but it can be used as an important indicator to evaluate the long-term prognosis of patients.
本研究旨在回顾中国接受升主动脉夹层（AAD）手术患者的升主动脉直径及其对预后的影响。
2018 年 1 月至 2020 年 1 月期间，本研究纳入了 265 名符合升主动脉分析条件的患者。使用术前计算机断层扫描（CT）评估患者升主动脉的最大直径。
参考人群升主动脉平均直径为 48.16±9.37mm，主动脉<55mm 的患者比例为 80.38%。本研究发现，BMI、高血压和二叶式主动脉瓣是影响升主动脉扩张的主要因素，AAD 患者的升主动脉直径与患者的长期预后呈负相关。然而，不同升主动脉直径患者的生存率无显著差异。
直径较小的升主动脉也容易发生夹层，其中大多数发生在低于现行指南推荐的手术阈值。因此，升主动脉直径不能作为主动脉夹层高危患者的独立危险因素，但可作为评估患者长期预后的重要指标。
