Aortic & peripheral vascular diseaseCohort study
Reappraisal of Surgical Threshold in Patients With Ascending Aortic Dilation
- cohort
- derivation cohort
- validation cohort
Authors' conclusion
Indexing AA dimensions to height better identifies high-risk AA patients, particularly women, who fall below surgical criteria. Further studies are needed to determine if this cohort may benefit from earlier intervention at lower size thresholds.
Study context
- Population
- Patients with ascending aortopathy (AA) (4–5 cm) diagnosed on echocardiography (2010–2023); patients with syndromic aortopathy and acute aortic dissection/rupture at presentation excluded68 ± 13 years, 79% men, 28% with bicuspid aortic valve · aortic surgery 2,196 · unoperated 8,887 · derivation cohort (unoperated) 3,887 · validation cohort 5,000
- Participants
- 11,083 patients
- Exposure
- operated group vs unoperated group
- operated groupn = 2,196
- unoperated groupn = 8,887
- Outcome
- Mortality
- Follow-up
- 6 ± 4 years
Main finding
As reported in the abstract
- Validation cohort: AA height index (AHI) ≥2.5 cm/m and cross-sectional area-to-height (CSAH) ≥9 cm²/m associated with higher long-term mortality
- both P < 0.05
Observational data: associations, not effects.
Further findings
Aortic dimensions
- Mean AA diameter
- 4.4 ± 0.2 cm
- Mean AHI
- 2.53 ± 0.3 cm/m
- Mean CSAH
- 8.8 ± 1 cm²/m
Safety
| Outcome | operated group | unoperated group |
|---|---|---|
| Aortic dissection and rupture | ||
| Aortic dissections | Not reported in the abstract | 128 (1.4%) |
| Aortic ruptures | Not reported in the abstract | 4 (0.04%) |
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Reappraisal of Surgical Threshold in Patients With Ascending Aortic Dilation. JACC Adv. Published 15 July 2026. doi:10.1016/j.jacadv.2026.102859
Summarised from the published abstract; every number is checked against it