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Controversies in Aortic Dissection and Aneurysmal Disease pp 67–84Cite as

Size Matters: Intervention Thresholds for Dissection Prophylaxis in the Ascending Aorta

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Abstract

This chapter provides an extensive review of the normal size of the ascending aorta, for different body surface areas including tall people. The different imaging techniques, by means of echocardiography, magnetic resonance and computed tomography, are extensively discussed, as well as pitfalls in size measurements. The size of the ascending aorta may increase due to aging or pathologic conditions. The authors consider an aortic root or ascending aorta diameter above 4.0 cm as abnormal. From a diameter of >4.0 cm begins a monitor-zone for extended diagnostic evaluation, treatment advices and pre-pregnancy counselling. From a diameter >4.5 cm, operative treatment of the ascending aorta is advised in patients with connective tissue disorders who have risk factors. From a diameter of >5.0 cm, operative treatment is advised in other cases of connective tissue disorders and in cases of bicuspid aortic valve with risk factors. From a diameter of >5.5 cm, operative treatment is advised in bicuspid aortic valve without risk factors and in all other cases.

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Authors and Affiliations

  1. Department of Cardiology, Gelre Hospital—Apeldoorn, Albert Schweitzerlaan 31, Apeldoorn, 7334 DZ, The Netherlands

    Luc Cozijnsen MD & Richard L. Braam MD, PhD

  2. Department of Cardiac Surgery, AZ St. Jan, Brugge, Ruddershove 10, Brugge, 8000, Belgium

    Marc A. A. M. Schepens MD, PhD

  3. Department of Cardiology, Academic Medical Center, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands

    Barbara J. M. Mulder MD, PhD

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  4. Barbara J. M. Mulder MD, PhD
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Correspondence to Luc Cozijnsen MD .

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  1. University Hospitals Birmingham, Queen Elizabeth Hospital, Birmingham, United Kingdom

    Robert S. Bonser

  2. University Hospitals Birmingham, Queen Elizabeth Hospital, Birmingham, United Kingdom

    Domenico Pagano

  3. Thoracic and Cardiovascular Surgery Depts., Hannover Medical School, Hannover, Germany

    Axel Haverich

  4. University Hospitals Birmingham, Queen Elizabeth Hospital & Centre, Birmingham, United Kingdom

    Jorge Mascaro

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Cozijnsen, L., Braam, R.L., Schepens, M.A.A.M., Mulder, B.J.M. (2014). Size Matters: Intervention Thresholds for Dissection Prophylaxis in the Ascending Aorta. In: Bonser, R., Pagano, D., Haverich, A., Mascaro, J. (eds) Controversies in Aortic Dissection and Aneurysmal Disease. Springer, London. https://doi.org/10.1007/978-1-4471-5622-2_4

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  • DOI: https://doi.org/10.1007/978-1-4471-5622-2_4

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