Aortic events and relative survival in patients with moderately dilated proximal thoracic aorta

Figures & data

Figure 1. Flowchart of the selection process identifying the final study group (n = 80) by applying exclusion criteria to the initially eligible patients, referred to an aortic outpatient clinic (n = 756).

Figure 2. Diagram (“spaghetti plot”) of proximal aortic diameter (y-axis) development over time (x-axis) in each patient (individual measure points not shown). Patients dying during the study period highlighted in red. Note logarithmic scale on x-axis.

Table 1. Clinical characteristics of 80 patients with moderately (45–54 mm) proximal thoracic aorta.

		n (%) or median (range)
Gender, male		52 (65)
Age, years		62.5 (34–80)
Chronic obstructive pulmonary disease		16 (20)
Diabetes		5 (6.2)
Hypertension		66 (82.5)
Warfarin use		12 (15)
Smoking	Never	35 (43.8)
	Prior	37 (46.2)
	Current	8 (10)
Body Mass Index, kg/m^2		25.5 (16–42.1)

Figure 3. Kaplan-Meier survival curves (with 95% confidence interval) for (panel A) freedom from all-cause death; (panel B) freedom from aortic death; (panel C) freedom from local (proximal aorta) event; (panel D) freedom from remote (distal aorta) event. Of local events, n = 11 (100%) were elective surgical repair. Of distal events, n = 6 (66%) were acute type B dissections.

Figure 4. Relative survival (observed versus expected) for patients with proximal aortic dilatation (solid line) versus age-, sex- and time period-matched normal population (cross-hatched line). At ten years of follow-up, relative survival was 82%.

Table 2. Deaths (n = 12) in 80 patients with moderately (45–54 mm) dilated proximal thoracic aorta, including aortic diameters at baseline and pre-event for both proximal and descending (i.e. affected) aortic segments.

			Proximal aortic diameter (cm)		Descending aortic diameter (cm)
Patient number	Gender	Age (years)	Baseline	Pre-event	Baseline	Pre-event	Cause of death
1	M	78	4.5	4.7			Cardiac
2	M	77	4.6	4.6			Cerebrovascular
3	M	77	5.2	5.2	6.2	6.6	TBAD
4	F	70	5.0	5.2			Malignancy
5	F	71	4.5	7.4	3.7	8.0	TBAD
6	M	72	4.8	4.8			Malignancy
7	F	72	4.5	5.1	4.2	6.3	TBAD
8	M	71	4.7	4.7			Cardiac
9	M	69	4.5	4.5			Cardiac
10	M	62	4.7	4.8	9.0	9.6	TBAD
11	M	59	4.5	4.5	3.5	4.2	TBAD
12	M	53	4.9	5.1	3.0	3.1	TBAD

TBAD: Type B aortic dissection.

Table 3. Local events: prophylactic surgical procedures (n = 11) on the proximal thoracic aorta.

			Proximal aortic diameter (cm)
Patient number	Gender	Age (years)	Baseline	Pre-event	Primary indication	Procedure
1	F	75	5.3	5.3	Asc	SCG
2	F	66	5.1	5.1	Asc + AR	Composite graft
3	F	66	4.5	4.5	Asc + AR	David
4	M	58	5.0	5.1	Asc	David
5	M	57	4.7	4.7	Asc	SCG
6	M	54	5.1	5.2	Asc + AS	AVR + SCG
7	M	53	4.9	4.9	Asc	David
8	M	55	5.4	5.4	Asc + AR/AS	Freestyle
9	F	46	5.2	5.2	Asc + AS	Freestyle
10	M	41	5.1	5.2	Asc + AR	David
11	M	39	5.0	5.0	Asc	David

AR: Aortic regurgitation; AS: Aortic stenosis; Asc: Ascending aorta; AVR: Aortic valve replacement; SCG: Supracoronary graft.

Table 4. Remote events (n = 9): type of primary event, associated procedure (if any), and diameters of proximal and affected aortic segments at baseline and pre-event.

			Proximal aortic diameter (cm)		Diameter at affected aortic segment (cm)
Patient number	Gender	Age (years)	Baseline	Pre-event	Baseline	Pre-event	Type of event	Procedure
1	M	78	4.5	4.5	4.8^a	4.8	Infrarenal rupture	Surgical repair
2	M	77	4.6	4.6	4.9^b	4.9	TBAD	None
3	F	70	5.0	5.0	4.9^b	6.0	Desc aneurysm	Endovascular repair
4	F	72	4.5	5.1	4.5^a	5.9	Infrarenal aneurysm	Surgical repair
5	M	65	4.7	4.7	3.6^b	3.6	TBAD	None
6	M	63	5.0	5.0	5.2^a	5.4	Infrarenal aneurysm	Surgical repair
7	M	59	4.5	4.5	4.1^b	4.1	TBAD	None
8	M	54	4.5	4.5	3.6^b	3.6	TBAD	None
9	M	52	4.7	4.7	3.8^b	3.8	TBAD	None

a Infrarenal aorta.

b Descending aorta.

TBAD: Type B aortic dissection.

Data availability statement

The data underlying this article will be shared on a reasonable request to the corresponding author.