Prevalence and Significance of Incidentally Noted Dilation of the Ascending Aorta on Routine Chest Computed Tomography in Older Patients

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The aim of this study was to determine the prevalence of incidental ascending aortic dilation and its significance over time in 55- to 80-year-olds undergoing routine computed tomographic scans.


Chest computed tomography reports for 64,092 patients who met the inclusion criteria were used to determine the prevalence of incidental ascending aortic dilation (4-5 cm) and, when possible, aortic growth rates. A chart review was performed to identify any aortic complication or intervention.


The prevalence of incidental aortic dilation was 2.7% (671/24,992 patients). Of the 327 patients with aortic dilation and follow-up studies (mean, 3.4 years), only 3.7% (n = 12) demonstrated interval growth (mean of 0.9 mm/y). No patient underwent prophylactic surgery or intervention on the basis of aortic size or growth rate. One patient developed a type A dissection.


Current guidelines for yearly surveillance imaging of aortic dilation could be revised to increase the follow-up interval and/or improve risk stratification to better identify the small subset of patients most likely to have disease progression.

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