Ascending Aortic Diameter after Dissection Does Not Reflect Size before Dissection

INTRODUCTION: Current guidelines for prophylactic resection of ascending aortic aneurysms are based on post-dissection aortic diameter. However, this may not reflect the diameter prior to dissection. REPORT: Pre- and post-dissection aortic diameters were compared in 34 patients with available computerised tomography scans. The median time interval between these scans was 536 days (interquartile range 354 – 1237). DISCUSSION: There was a statistically significant difference in diameters from the sinotubular junction to the proximal abdominal aorta, the largest was in the ascending aorta with a mean of 7.6 mm (standard deviation 4.5). This suggests that the ascending aortic diameter is a poor predictor of dissection in most patients.