Copyright 2017 The American Association for Thoracic Surgery. As part of our ongoing investigations into the natural history of thoracic aortic aneurysm (TAA), our database at the Aortic Institute at YaleNew Haven Hospital currently includes a total of 3349 patients with TAA. 17-23 These studies are, however, limited by either number of participants, 17-19 fewer aortic landmarks included in the measurements 20, 21 or using non-contrast enhancement CT, 22, 23 for example, previously reported normal . If an abnormality is detected or suspected, dedicated imaging with MRA to assess aortic dimensions is warranted. V xl/workbook.xmlTn0?+Z,y,( q/4EYD$R%FPe.o,SK` *S.v Y/!FB Activity restrictions for patients with thoracic aortic aneurysm are largely based on theory and empirical experience, and certain activities may require more modification than others. About: This set of echocardiography calculators (formerly known as CardioMath) has been used by thousands of clinicians from nearly every country on the globe for over a decade. It predicts the mean diameter of the ascending aorta and the length of the ascending aorta, measured from the aortic annulus to the branching point of the brachiocephalic trunk in a curved planar reformation (CPR). For patients presenting for the first time with an aneurysm, it is reasonable to obtain definitive aortic imaging with CT or magnetic resonance angiography (MRA), then to repeat imaging at six months to document stability. For the purpose of this study, the ascending aorta and arch (from the aortic annulus to the left subclavian artery) were considered one unit, and the descending thoracic and thoracoabdominal portions (distal to the left subclavian artery) was considered a separate unit, reflecting the natural dichotomy of TAA disease above and below the ligamentum arteriosum (nonarteriosclerotic and arteriosclerotic, respectively). It is possible that some of the products on the other site are not approved in your region or country. Compared with indices including weight, the simpler height-based ratio (excluding weight and BSA calculations) yields satisfactory results for evaluating the risk of natural complications in patients with TAAA. For example, heavy lifting should be discouraged, as it may increase blood pressure significantly for short periods of time.1,2 The increased wall stress, in theory, could initiate dissection or rupture. This calculator
Patient Prosthesis Mismatch In the event of a discrepancy, data were reevaluated in a core meeting. We defined bovine aortic arch as the union of the innominate and left carotid arteries cranial to the plane of the greater curvature of the aortic arch. Background: In international guidelines, risk estimation for thoracic ascending aortic aneurysm (TAAA) is based on aortic diameter. The BSA index will be referred to as aortic size index (ASI) to establish consistency with previously published terminology.22 Measures of body size and their respective aortic indices were divided into clinically relevant catego- Natural history of descending thoracic and thoracoabdominal aortic aneurysms. 2017, 2017 Published by Elsevier Inc. on behalf of The American Association for Thoracic Surgery, We use cookies to help provide and enhance our service and tailor content. eCollection 2023. A dream come true? The average annual rate of adverse events (rupture, dissection, rupture or dissection, death (each alone separately), and a composite of rupture, dissection, and death) in 6 groups of aortic sizes was calculated by number of occurrences over the average duration of observations as follows: Growth rate estimates of the ascending aorta were obtained using an instrumental variables approach as previously described by our group. Finding an aortic aneurysm before it ruptures offers your best chance of recovery. The equation will look like this: As you can see, this value is not within the normal aortic valve area range. Choose from 400+ evidence-based medical calculators- including clinical equations, scores, and dosage formulas for optimal patient treatment at the point of care Aneurysm syndromes caused by mutations in the TGF-beta receptor. However, it is unclear whether the weight . If a patients aortic size remains stable over time, he or she may be followed by the cardiologist until a significant size has been reached or growth has been documented, at which time the patient and surgeon can reconvene to discuss options for definitive treatment. Observational study of regional aortic size referenced to body size: production of a cardiovascular magnetic resonance nomogram. Survival model predictive accuracy and ROC curves. Natural history of isolated abdominal aortic dissection: A prospective cohort study. Yearly rates of adverse events related to ascending aortic aneurysm size. MeSH 1 Unauthorized use of these marks is strictly prohibited. Elefteriades JA. Based on the results of this study, an AHI of 2.43cm/m indicates low risk, but regular radiographic follow-up is recommended. Subjects with inuential predictors or mani- Disclaimer.
1,2 This is based on a sharp rise in the risk of . While there are no published guidelines regarding activity restrictions in patients with thoracic aortic aneurysm, we use a graded approach based on aortic diameter: We also recommend not lifting anything heavier than half of ones body weight and to avoid breath-holding or performing the Valsalva maneuver while lifting. The tables in the present study include rupture, dissection, and death in the calculations. Dr. Roselli is Surgical Director of the Aorta Center. 2014 AHA/ACC guideline for the management of patients with valvular heart disease: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. The third additional method is using the velocity ratio (also called dimensionless index). Relationship of aortic cross-sectional area to height ratio and the risk of aortic dissection in patients with bicuspid aortic valves.
Aortic diameters and long-term complications among 780 patients with TAAA were analyzed. References: Normal limits in relation to age, body size and gender of two-dimensional echocardiographic aortic root dimensions in persons 15 years of age. However, weight might not contribute substantially to aortic size and growth. When we used the BSA-based index, we always wondered how the aorta knew how heavy the patient was, and how the weight would affect the normal size of the aorta for that patient. is rarely associated with significant elevations in blood pressure and should be encouraged. This investigation was approved by the Human Investigation Committee of the Yale University School of Medicine. Relationship of aortic cross-sectional area to height ratio and the risk of aortic dissection in patients with bicuspid aortic valves. Svensson LG, Khitin L. Aortic cross-sectional area/height ratio timing of aortic surgery in asymptomatic patients with Marfan syndrome. #^ NpnL9+>IUKsuIu)7[.p`,%K&LXA9 ++-/964^Td[@? Risk stratification was performed using regression models. Sex Age [years] 60 Height [cm] 175 Weight [kg] 80 ascending aorta diameter, mean [mm] ascending aorta diameter, +2SD [mm] (threshold diameter) ascending aorta length, mean [mm] ascending aorta length, +2SD [mm] (threshold length) August 31, Front Physiol. To avoid high-risk emergency surgery on an acutely dissected aorta, surgery on an ascending aortic aneurysm of degenerative etiology is usually suggested when the aneurysm reaches 5.0 to 5.5 cm or a documented growth rate greater than 0.5 cm/year.1,5, Additionally, in patients already undergoing surgery for valvular or coronary disease, prophylactic aortic replacement is recommended if the ascending aorta is larger than 4.5 cm. Velocity Ratio.
Epub 2019 Feb 13. Below, we present an aortic valve area formula: Cleveland Clinic 1995-2023. Roughly the diameter of a garden hose, the artery extends from your heart down through your chest and into your abdomen, where it divides into a blood . AVA\text{AVA}AVA - Aortic valve area in cm2\text{cm}^2cm2; LVOT\text{LVOT}LVOT - Left ventricular outflow tract diameter, in cm\text{cm}cm; VT1V_{\text{T}_1}VT1 - Subvalvular velocity time integral, in cm\text{cm}cm; and. Aortic Root Z-Scores for Children For patients up to 25 years of age: utilizing systole, inner to inner edge measurement of the sinuses of valsalva according to personal communication from Steve Colan.
Patients were stratified into 4 categories of yearly risk of complications based on their ASI and AHI. A Z score of zero means that the aortic measurement is the average size for a girl with TS with that height and weight.
Average annual growth rate of the ascending aorta based on initial aneurysm size. Eur J Cardiothorac Surg. Aortic Root Z-Scores for Adults For patients > 15 years of age and adults: utilizing diastole and leading edge-to-leading edge measurement of the sinuses of valsalva. Updated standardized endpoint definitions for transcatheter aortic valve implantation: the Valve Academic Research Consortium-2 consensus document (VARC-2). The below equation relies on the ratio of peak-to-peak instantaneous gradients. Aortic cross-sectional area/height ratio and outcomes in patients with a trileaflet aortic valve and a dilated aorta. Growth rate estimates, yearly complication rates, and survival were assessed. Advertising on our site helps support our mission.
cited by this calculator preceded the publication of the 2010 ASE Guidelines. Wolak A, Gransar H, Thomson LE, Friedman JD, Hachamovitch R, Gutstein A, Shaw LJ, Polk D, Wong ND, Saouaf R, Hayes SW, Rozanski A, Slomka PJ, Germano G, Berman DS. Clinical calorimetry: tenth paper: a formula to estimate the approximate surface area if height and weight be known. commonly reported for conditions such as Marfan syndrome, bicuspid aortic valve, and Kawasaki disease. Authors have nothing to disclose with regard to commercial support. J Am Coll Cardiol Img. Size thresholds for surgical intervention are discussed below, but one should not wait until these thresholds are reached to send the patient for surgical consultation. The aneurysmal innominate artery and the left common carotid artery were resected. Message from the Emeritus Director. But if one person is heavier than the other (and thus has a greater BSA), the ASI will assign the heavier individual a lower risk of adverse events. The overall distribution of aortic sizes of the patient cohort is depicted in, The estimated average yearly growth rate obtained by means of regression analysis was 0.14 0.02 cm/year: Larger aneurysms grew faster; a 3.5-cm ascending aorta grew at 0.11cm/year, whereas a 7.0-cm aorta grew at 0.22cm/year (, The average yearly rates of adverse events (rupture, dissection, and death) for 6 categories of ascending aortic sizes are presented in, An analysis of the estimated probability of risk of rupture and dissection at various aortic sizes revealed that the risk increased sharply between 5.25 and 5.5cm and then again between 5.75 and 6cm (, The 5-year complication-free survival is illustrated for ascending aortic aneurysm patients as a function of AHI and ASI in, The 5-year survival functions estimated using Cox proportional hazards regression and stratified by ASI and AHI are shown in, Cox proportional hazard regression analysis (, Patients were stratified into 4 categories of yearly risk of complications (rupture, dissection, and death) based on their ASI and AHI (. The aortic size index (ASI) is a means of adjusting the absolute aortic diameter to take into account the patient's physical size. Dr. Desai is Professor of Medicine in the Cleveland Clinic Lerner College of Medicine and Medical Director of Cleveland Clinics Aorta Center. Z-scores of the aortic root (aortic annulus, sinuses of Valsalva, sinotubular junction, and ascending aorta) are
Raw data was not published; the normality of the sizes within the raw data therefore could not be verified. Numbers of patients with IAAs exceeding 10 cm 2 /m are shown in Table 4.The results reflect the fact that the IAA can exceed 10 cm 2 /m at several aortic locations in a given patient. Update my browser now. In 2006, our group presented a nomogram that allowed interpretation of aortic size significance in relationship to a patient's body surface area (BSA). We do not endorse non-Cleveland Clinic products or services Policy. We previously introduced the aortic size index (ASI), defined as aortic size/body surface area (BSA), as a predictor of aortic dissection, rupture, and death. Now we find that we can indeed leave the patient's weight out of consideration, with equal or better discriminatory power. The primary aim of this study was to investigate if ASI is a predictor of development AAA, and to compare the predictive impact of ASI to that of the absolute AD. If you don't remember your password, you can reset it by entering your email address and clicking the Reset Password button. Aortic Institute at Yale-New Haven Hospital, Yale University School of Medicine, New Haven, Conn, Department of Political Sciences and Economics, Rowan University, Glassboro, NJ, Department of Economics and Department of Preventive Medicine, Stony Brook University, Stony Brook, NY, Department of Vascular Surgery, Yale University School of Medicine, New Haven, Conn, Department of Cardiac Surgery, University Hospital Munich, Ludwig Maximilian University, Munich, Germany.
10 However, there are many shortcomings of making clinical decisions on the basis of aortic z scores . Saeyeldin A, Zafar MA, Li Y, Tanweer M, Abdelbaky M, Gryaznov A, Brownstein AJ, Velasquez CA, Buntin J, Thombre K, Ma WG, Erben Y, Rizzo JA, Ziganshin BA, Elefteriades JA. If a mutation is identified in a family, then first-degree relatives should undergo genetic screening for the mutation and aortic imaging.1 Imaging in second-degree relatives may also be considered if one or more first-degree relatives are found to have aortic dilation.1. Aortic diameter > or = 5.5 cm is not a good predictor of type A aortic dissection: observations from the International Registry of Acute Aortic Dissection (IRAD). However, moderate-intensity aerobic activity such as jogging, cycling, walking, etc. The full article, which includes a couple of illustrative case vignettes, is freely available at this link. Michelena HI, Khanna AD, Mahoney D, et al. Generally, an aneurysm expands over a period at the rate of 10% per annum. The aortic arch was excised. Conclusions: Experimental confirmation of effectiveness of fenestration in acute aortic dissection. To a cardiologist at the time of diagnosis. Background: Aortic sized index (ASI) defined as aortic dimensions/body surface area (BSA), has been proposed as a method of identifying aortic dilatation in Turner syndrome. This avoids the need to calculate BSA from a computer site. Individuals with a dilated ascending aorta defined as aortic size index >2.0 cm/m 2 require close cardiovascular surveillance. Now you know how to calculate aortic valve area. This condition is associated with the restriction of the blood flow from the left ventricle to the aorta, which can also affect the pressure in the left atrium. contributed equally to this work. Ross procedure. Tzemos N, Therrien J, Yip J, et al. How does the ascending aorta geometry change when it dissects?. Both ASI and AHI were shown to be significant predictors of complications (P < .05). The purpose of this study was to investigate the benefit of aortic volumes compared to diameters or cross-sectional areas on three-dimensional (3D) ma A drawback of using aortic diameter in this regard for risk estimation is the inability to factor in a significant determinant of aortic dimensions: the patient's body size. Where: Stroke volume = Cardiac Output / Heart rate in bpm. When the left ventricle contracts, the pressure rises in the left ventricle, and once it is above the pressure in the aorta, the aortic valve to open and allows blood flow into the aorta and thereby into the rest of the body. Mosteller RD (1987) Simplified calculation of body . This study is limited by its retrospective nature and by potential bias in patient referral. 1,15. SVI is very easy to compute and involves the following equation: Stroke volume index = Stroke volume in mL / Body surface area in m 2. However, rarely are thoracic aneurysms symptomatic unless they rupture or dissect. All aortic diameter measurements were doubly confirmed by the senior author (J.A.E.) Activity restrictions should be reviewed at the initial evaluation. aneurysm diameter (in cm) by each measure of body size; for example, BSA index aneurysm diameter (cm)/BSA (m2). Epub 2018 Feb 2.
Eur J Cardiothorac Surg. Wu J, Wu Y, Li F, Zhuang D, Cheng Y, Chen Z, Yang J, Liu J, Li X, Fan R, Sun T. Front Cardiovasc Med. This study of the natural history of TAAA permits the following conclusions: The natural risk of rupture and dissection based on aortic size increases sharply at 2 hinge points: 5.25 to 5.50cm and 5.75 to 6.00cm. However, we came to suspect that a patient's weight might not contribute substantially to aortic size and growth. official website and that any information you provide is encrypted This patient has mild aortic stenosis. 2019 May;157(5):1733-1745. doi: 10.1016/j.jtcvs.2018.09.124. Does being overweight reduce accuracy in predicting an acute aortic dissection?
Click OK to confirm you are a Healthcare Professional. Calculation of percentiles utilizes the published averages and standard deviations for the binned age and BSA groups and assumes a normal distribution of size diameters within each interval.
A aortic size index (ASI) is the aortic structure index (BSA), which is divided into three parts. The aortic size index (ASI) is defined as the AD divided by BSA. Thoracic aortic aneurysm: reading the enemys playbook. Risk of complications (aortic dissection, rupture, and death) in patients with ascending aortic aneurysm as a function of aortic diameter (horizontal axis) and height (vertical axis), with the aortic height index given within the figure. Aortic size index (ASI) of men and women undergoing abdominal aortic aneurysm (AAA) repair is shown by gender and rupture status. December 4, 2018;72(22):2701-2711. Recent evidence indicates that the aorta grows by 7 to 8mm at the instant of dissection. DOI: https://doi.org/10.1016/j.jtcvs.2017.10.140. PMC No. However, weight might not contribute substantially to aortic size and growth.
Circulation. The coefficient estimates for both ASI and AHI demonstrate a statistically significant effect on the complication rate (. In international guidelines, risk estimation for thoracic ascending aortic aneurysm (TAAA) is based on aortic diameter. This post is excerpted and adapted from a recent review article in Cleveland Clinic Journal of Medicine (2018[June];85:481-492), focusing on that articles discussion of management of thoracic aortic aneurysm following diagnosis and classification. Thoracic aortic aneurysm growth: role of sex and aneurysm etiology. Indications and imaging for aortic surgery: size and other matters. Data are expressed as meanstandard deviation and range for continuous variables and as number (percentage) for categorical variables. Among these, 780 patients with a TAAA, with a total of 1272 ascending aortic size measurements and a mean radiologic follow-up of 47.7months (range, 5days to 256.7months), compose a subset in which all radiologic studies were reread and reanalyzed in a standardized manner. Wu J, Zafar MA, Li Y, Saeyeldin A, Huang Y, Zhao R, Qiu J, Tanweer M, Abdelbaky M, Gryaznov A, Buntin J, Ziganshin BA, Mukherjee SK, Rizzo JA, Yu C, Elefteriades JA. We sometimes recommend exercise stress testing to assess the heart rate and blood pressure response to exercise, and we are developing research protocols to help tailor activity recommendations. It is located between the left ventricle and the aorta, and this is the last structure in the heart blood flows through before it enters systematic circulation. 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM guidelines for the diagnosis and management of patients with thoracic aortic disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine. 2023 Feb 28;13(1):38-50. doi: 10.21037/cdt-22-477. Prevention of aortic dissection suggests a diameter shift to a lower aortic size threshold for intervention. The ascending aorta was opened. Hiratzka LF, Creager MA, Isselbacher EM, et al. THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY RECOMMENDATIONS FOR CARDIAC CHAMBER QUANTIFICATION IN ADULTS: A QUICK REFERENCE GUIDE FROM THE ASE WORKFLOW AND LAB MANAGEMENT TASK FORCE Accurate and reproducible assessment of cardiac chamber size and function is essential for clinical care. Patients with an AHI of 3.21 to 4.06cm/m are at high risk, and elective aortic repair should generally be recommended. Recommending elective surgery for proximal thoracic aortic pathology at a given diameter remains a dynamic process, periodically shifting a few millimeters up or down the scale along with the current literature and the current perception. In international guidelines, risk estimation for thoracic ascending aortic aneurysm (TAAA) is based on aortic diameter. . Transcatheter Aortic Valve Implantation We hope this nomogram is useful to clinicians in the difficult process of making the decision to proceed with prophylactic aortic surgery based on aortic diameter in asymptomatic patients. Aortic Size Assessment by Noncontrast Cardiac Computed Tomography: Normal Limits by Age, Gender, and Body Surface Area. The highest IAA was found at the mid-ascending aorta location, where 56.7% of aneurysm group patients, and 60.6% of dissection group patients, had abnormally high IAAs. Stressful emotional states have been anecdotally associated with aortic dissection; thus, measures to reduce stress may offer some benefit.2. If the aortic dimensions remain stable, annual follow-up with CT or MRA is reasonable.1. aortic height index; aortic rupture; ascending aorta; death; dissection; natural history; risk estimation; thoracic aortic aneurysm. Derivation from the graph published in the article (figure 2) was therefore necessary. National Library of Medicine Karazincir S. et al., "CT assessment of main pulmonary artery diameter," Diagnostic and Interventional Radiology 14(2), 72-74 (2008), Density and QQ plots of raw data, and QQ plot of the Box-Cox transformed data. We previously introduced the aortic size index (ASI), defined as aortic size/body surface area (BSA), as a predictor of aortic dissection, rupture, and death. The following flow chart outlines our approach to initial screening and follow-up. At our center, we routinely recommend screening of all first-degree relatives of patients with thoracic aortic aneurysm if there is a suggestion of a family history.
This information was most useful for very small and very large patients. This site needs JavaScript to work properly. FOIA This produces a simple nomogram, permitting better categorization of patients with aortic aneurysm into low, moderate, high, or severe aortic risk categories. Statistical analysis was performed using R 3.1.0 (R Foundation for Statistical Computing, Vienna, Austria). Natural history of thoracic aortic aneurysms: indications for surgery, and surgical versus nonsurgical risks. Objective: To investigate the influence of indexation on the prevalence of severe aortic stenosis and on the predictive . Aortic Root Z-Score Calculator Data Input Form Z-scores of the aortic root (aortic annulus, sinuses of Valsalva, sinotubular junction, and ascending aorta) are commonly reported for conditions such as Marfan syndrome, bicuspid aortic valve, and Kawasaki disease. AHI categories 3.05 to 3.69, 3.70 to 4.34, and 4.35 cm/m were associated with a significantly increased risk of complications (P < .05). Aortic size index (ASI), which indexes the aortic diameter to body surface area, was proposed as a more sensitive measure to determine threshold for repair.
Lo RC, Lu B, Fokkema MT, Conrad M, Patel VI, Fillinger M, Matyal R, Schermerhorn ML; Vascular Study Group of New England,. No gender difference in the degree of dilatation with increasing BSA was seen (p>0.5). However, measurements from TEE and TTE were used only if they pertained to the proximal ascending aorta, because of the inability of these modalities to adequately visualize the upper portions of the ascending aorta. Indexing absolute aortic size to biometric data is a valid tool for risk estimation of rupture, dissection, or death in patients with TAAA. This produces a simple nomogram, permitting better categorization of patients with aortic aneurysm into low, moderate, high, or severe aortic risk categories.
This aortic size index (ASI) nomogram ( Figure 5) has been widely adopted. The ratio of aortic cross-sectional area to the patient's height has also been applied to patients with bicuspid aortic valve-associated . The impact of prosthesis-patient mismatch on long-term survival after aortic valve replacement: a systematic review and meta-analysis of 34 observational studies comprising 27 186 patients with 133 141 patient-years. Online ahead of print.
Healthcare Professionals Patients with an LV ejection fraction of 36-49% are defined as 'impaired LV ejection fraction'. Flameng W, Herregods MC, Vercalsteren M, Herijgers P, Bogaerts K, Meuris B. Prosthesis- patient mismatch predicts structural valve degeneration in bioprosthetic heart valves. It is important to keep in mind that natural history studies on the aorta, and the calculations in this study, are based on observed size at the time of dissection. However, weight might not contribute substantially to aortic size and growth. Advertising on our site helps support our mission. Last updated: 30 Mar 2013|Home|About|Contact|Disclaimer|Top, measurements are made in systole, at the moment of maximum expansion, measurements are made from "inside edge-to-inside" edge, i.e., the intraluminal dimension, the aortic valve is measured from the hinge points (inner edges), vascular measurements are made perpendicular to the long axis of the vessel, vascular measurements are made at end-diastole, measurements are made from "leading edge-to-leading edge". J Thorac Cardiovasc Surg. Dr. Kalahasti is Medical Director of the Marfan and Connective Tissue Disorder Clinic in the Aorta Center. Based on the ASI, patients were stratified in to three risk categories and surgical intervention was recommended for . Epub 2023 Feb 10. Home Kappetein AP, Head SJ, Gnreux P, et al. Read the article below to get familiar with the aortic valve area formula and reference values for this measurement. Epub 2019 Sep 13. PK ! Now, as our aortic patient database has grown from 230 at the time of our original publications to some 4000 today, we are able to make much more powerful statistical calculations. How does this stroke volume index calculator work? In adults with normal aortic valves, the valve area is approximately 3.0 to 4.0 cm 2. Natural history of thoracic aortic aneurysms: indications for surgery, and surgical versus nonsurgical risks. The aneurysmal innominate artery and the left common carotid artery were resected. Background To account for differences in body size in patients with aortic stenosis, aortic valve area (AVA) is divided by body surface area (BSA) to calculate indexed AVA (AVA index ). Dr. Svensson is a cardiothoracic surgeon and Chairman of Cleveland Clinics Miller Family Heart & Vascular Institute. 2012 Oct 15;110 (8):1189-94. Methods: Using relevant parameters, we don't calculate the surface area directly from geometric measurements! We read with great interest and pleasure the article by Zafar and colleagues. This method still measures the effective orifice area (EOA), which is the primary predictor of outcomes. For this risk of complication analysis, the aortic size groups were divided with 0.5-cm breakdown points (3.5-3.9, 4.0-4.4, 4.5-4.9, 5.0-5.4, 5.5-5.9, 6.0cm), and 4.0 to 4.4cm was set as the comparison group. Key clinicians from our Aorta Center share guidance on care from referral to medical and surgical management to patient and family follow-up. An AHI of 2.44 to 3.17cm/m indicates moderate risk and warrants at least close radiographic follow-up.
J Am Coll Cardiol. In this article, we demonstrate that compared with the BSA-based ASI, the height-based aortic height index (AHI) provides equal or superior prediction of aortic events, as depicted in the area under the curve analysis.
Table 3 Threshold values of the diameters, aortic size index, and aortic height index indicating the upper two standard deviations (2 SD, 95%) of the normally distributed data in the subgroup of patients with no hypertension, coronary artery disease, or bicuspid or mechanical aortic valve .
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