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

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Abstract

Objective

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.

Methods

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.

Results

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.

Conclusions

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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