Variants of the aortic arch in adult general population and their association with thoracic aortic aneurysm disease.

Autor: Yousef S; Division of Cardiac Surgery, Yale University School of Medicine, New Haven, Connecticut, USA., Singh S; Division of Cardiac Surgery, Yale University School of Medicine, New Haven, Connecticut, USA., Alkukhun A; Division of Radiology, Yale University School of Medicine, New Haven, Connecticut, USA., Alturkmani B; Division of Radiology, Yale University School of Medicine, New Haven, Connecticut, USA., Mori M; Division of Cardiac Surgery, Yale University School of Medicine, New Haven, Connecticut, USA., Chen J; Division of Cardiac Surgery, Yale University School of Medicine, New Haven, Connecticut, USA., Mullan CW; Division of Cardiac Surgery, Yale University School of Medicine, New Haven, Connecticut, USA., Brooks CW; Division of Cardiac Surgery, Yale University School of Medicine, New Haven, Connecticut, USA., Assi R; Division of Cardiac Surgery, Yale University School of Medicine, New Haven, Connecticut, USA., Gruber PJ; Division of Cardiac Surgery, Yale University School of Medicine, New Haven, Connecticut, USA., Cortopassi I; Division of Radiology, Yale University School of Medicine, New Haven, Connecticut, USA., Geirsson A; Division of Cardiac Surgery, Yale University School of Medicine, New Haven, Connecticut, USA., Vallabhajosyula P; Division of Cardiac Surgery, Yale University School of Medicine, New Haven, Connecticut, USA.
Jazyk: angličtina
Zdroj: Journal of cardiac surgery [J Card Surg] 2021 Jul; Vol. 36 (7), pp. 2348-2354. Date of Electronic Publication: 2021 Apr 14.
DOI: 10.1111/jocs.15563
Abstrakt: Background: Query a single institution computed tomography (CT) database to assess the prevalence of aortic arch anomalies in general adult population and their potential association with thoracic aortopathies.
Methods: CT chest scan reports of patients aged 50-85 years old performed for any indication at a single health system between 2013 and 2016 were included in the analysis. Characteristics of patients with and without aortic arch anomalies were compared by t test and Fisher exact tests. Logistic regression analysis was performed to assess for independent risk factors of thoracic aortic aneurysm (TAA).
Results: Of 21,336 CT scans, 603 (2.8%) described arch anomalies. Bovine arch (n = 354, 58.7%) was the most common diagnosis. Patients with arch anomalies were more likely to be female (p < .001), non-Caucasian(p < .001), and hypertensive (p < .001). Prevalence of TAA in arch anomalies group was 10.8% (n = 65) compared to 4.1% (n = 844) in the nonarch anomaly cohort (p < .001). The highest prevalence of thoracic aneurysm was associated with right-sided arch combined with aberrant left subclavian configuration (33%), followed by bovine arch (13%), and aberrant right subclavian artery (8.2%). On binary logistic regression, arch anomaly (OR = 2.85 [2.16-3.75]), aortic valve pathology (OR 2.93 [2.31-3.73]), male sex (OR 2.38 [2.01-2.80]), and hypertension (OR 1.47 [1.25-1.73]) were significantly associated with increased risk of thoracic aneurysm disease.
Conclusions: Reported prevalence of aortic arch anomalies by CT imaging in the older adult population is approximately 3%, with high association of TAA (OR = 2.85) incidence in this subgroup. This may warrant a more tailored surveillance strategy for aneurysm disease in this subpopulation.
(© 2021 Wiley Periodicals LLC.)
Databáze: MEDLINE
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