Analysis of patients with thoracic aortic aneurysm taking into account risk factors, procedure and prognosis in 5-year clinical observation
Józefa Dąbek 1  
,   Katarzyna Potyka 2  
,   Paweł Skorus 2  
,   Michał Swoboda 2  
,   Zbigniew Tadeusz Gąsior 1  
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Katedra i Klinika Kardiologii, Wydział Nauk o Zdrowiu w Katowicach, Śląski Uniwersytet Medyczny w Katowicach
Studenckie Koło Naukowe przy Katedrze i Klinice Kardiologii, Wydział Nauk o Zdrowiu w Katowicach, Śląski Uniwersytet Medyczny w Katowicach
Józefa Dąbek   

Katedra i Klinika Kardiologii, Wydział Nauk o Zdrowiu w Katowicach, Śląski Uniwersytet Medyczny w Katowicach, ul. Ziołowa 47, 40-635 Katowice
Ann. Acad. Med. Siles. 2018;72:193–202
Aneurysms are characterized by widening of the arterial lumen by more than 50% in diameter in comparison to the normal dimensions of the aortic segment. They are often detected accidentally while performing other tests. Aneurysms are divided into two types: true and dissecting.

Material and methods:
All the patients who were diagnosed with a thoracic aortic aneurysm, hospitalized in the Cardiology Department in 2010–2014 were included in the study. The study group consisted of 50 patients aged 33 to 92 years, the mean age was 64 years. Among them there were 9 women and 41 men. The analysis was based on the occurrence of risk factors gathered from the history of the disease and the results of examinations, including imaging tests, treatment and prognosis.

25 persons (50%) were in the group treated conservatively and the other 25 subjects (50%) were treated surgically. The most common predisposing factors were: hypertension (n = 42; 84%), dyslipidemia (n = 25; 50%), ischemic heart disease (n = 20; 40%), smoking (n = 14; 28%) and family history (n = 14; 28%). Surgical treatment was the most frequently chosen in patients with dissecting aneurysms (n = 23; 60.5%). Nevertheless, conservative treatment was preferred with patients with a true aneurysm (n = 10; 83.3%).

The study group had a great number of risk factors. Analysis of the treatment did not show the superiority of any of the methods used (surgical vs. pharmacological) and the mortality rate during hospitalization in both groups was comparable.

Klisiewicz A., Michałowska I., Marczak M., Płońska-Gościniak E., Hoffman P. Choroby aorty we współczesnej diagnostyce obrazowej. Stanowisko grupy ekspertów polskiego Klinicznego Forum Obrazowania Serca i Naczyń. Kardiol. Pol. 2013; 71(6): 640–649.
Evangelista A., Flachskampf F.A., Erbel R., Antonini-Canterin F., Vlachopoulos C., Rocchi G., Sicari R., Nihoyannopoulos P., Zamorano J. Echocardiography in aortic diseases: EAE recommendations for clinical practice. Eur. J. Echocardiogr. 2010; 11(8): 645–658, doi: 10.1093/ejechocard/jeq056.
Agmon Y., Khandheria B.K., Meissner I., Schwartz G.L., Sicks J.D., Fought A.J., O'Fallon W.M., Wiebers D.O., Tajik A.J. Is aortic dilatation an atherosclerosis-related process? Clinical, laboratory, and transesophageal echocardiographic correlates of thoracic aortic dimensions in the population with implications for thoracic aortic aneurysm formation. J. Am. Coll. Cardiol. 2003; 42(6): 1076–1083.
Kim H.W., Stansfield B.K. Genetic and Epigenetic Regulation of Aortic Aneurysms. BioMed Res. Int. 2017; 2017: 7268521, doi: 10.1155/2017/7268521.
Milanowska B., Michalak E., Janaszek-Sitkowska H., Franaszczyk M., Płoski R., Bilińska Z.T. Rodzinne tętniaki i rozwarstwienia aorty piersiowej. Kardiol. Pol. 2011; 69(12): 1291–1297.
Bugajski P., Greberski K., Angerer D., Jarząbek R., Jedliński I., Greberska W., Kalawski R. Debranching of aortic arch as part of a complex cardiac surgery. Kardiol. Pol. 2013; 71(5): 502–504, doi: 10.5603/KP.2013.0097.
LeMaire S.A., Russell L. Epidemiology of thoracic aortic dissection. Nat. Rev. Cardiol. 2011; 8(2): 103–113, doi: 10.1038/nrcardio.2010.187.
Nienaber C.A., Eagle K.A. Aortic dissection: new frontiers in diagnosis and management: Part I: from etiology to diagnostic strategies. Circulation 2003; 108(5): 628–635, doi: 10.1161/01.CIR.0000087009.16755.E4.
Tsagakis K., Tossios P., Kamler M., Benedik J., Natour D., Eggebrecht H., Piotrowski J., Jakob H. The DeBakey classification exactly reflects late outcome and re-intervention probability in acute aortic dissection with a slightly modifiedtype II definition. Eur. J. Cardiothorac. Surg. 2011; 40(5): 1078–1084, doi: 10.1016/j.ejcts.2011.03.037.
Ruddy J.M., Jones J.A., Ikonomidis J.S. Pathophysiology of thoracic aortic aneurysm (TAA): is it not one uniform aorta? Role of embryologic origin. Prog. Cardiovasc. Dis. 2013; 56(1): 68–73, doi: 10.1016/j.pcad.2013.04.002.
Albornoz G., Coady M.A., Roberts M., Davies R.R., Tranquilli M., Rizzo J.A., Elefteriades J.A. Familial thoracic aortic aneurysms and dissections – incidence, modes of inheritance, and phenotypic patterns. Ann. Thorac. Surg. 2006; 82(4): 1400–1405.
Miller C.P., Firoozan S., Woo E.K., Apps A. Chronic cough: a herald symptom of thoracic aortic aneurysm in a patient with a bicuspid aortic valve. BMJ Case Rep. 2014; 2014: bcr2014205005, doi: 10.1136/bcr-2014-205005.
Baumann F., Makaloski V., Diehm N. Aortic aneurysms and aortic dissection: epidemiology, pathophysiology and diagnostics. Internist (Berl). 2013; 54(5): 535–542, doi: 10.1007/s00108-012-3217-0.
Agarwal P.P., Chughtai A., Matzinger F.R., Kazerooni E.A. Multide-tector CT of thoracic aortic aneurysms. Radiographics 2009; 29(2): 537–552, doi: 10.1148/rg.292075080.
Staromłyński J., Smoczyński R., Suwalski P. Małoinwazyjne leczenie tętniaków korzenia aorty z towarzyszącą niedomykalnością zastawki aortalnej z jej zachowaniem. Kardiol. Inwazyjna 2016; 11: 27–29.
Milanowska B., Michalak E., Michałowska I., Szpakowski E., Konopka A., Klisiewicz A., Bilińska Z.T. A fatal outcome of thoracic aortic aneurysm in a male patient with bicuspid aortic valve. Postępy Kardiol. Interwencyjnej 2013; 9(3): 265–271, doi: 10.5114/pwki.2013.37507.
Cheung K., Boodhwani M., Chan K.L., Beauchesne L., Dick A, Coutinho T. Thoracic Aortic Aneurysm Growth: Role of Sex and Aneurysm Etiology. J. Am. Heart Assoc. 2017; 6(2): e003792, doi: 10.1161/JAHA.116.003792.
Emrecan B., Durna F., Girgin S., Alshalaldeh M. Proximal aortic arch cannulation for proximal ascending aortic aneurysms. Kardiochir. Torakochir. Pol. 2014; 11(2): 132–135, doi: 10.5114/kitp.2014.43838.
Liu O., Xie W., Qin Y., Jia L., Zhang J., Xin Y., Guan X., Li H., Gong M., Liu Y., Wang X., Li J., Lan F., Zhang H. MMP-2 gene polymorphisms are associated with type A aortic dissection and aortic diameters in patients. Medicine 2016; 95(42): e5175.
Robertson E.N., Hambly B.D., Jeremy R.W. Thoracic aortic dissection and heritability: forensic implications. Forensic. Sci. Med. Pathol. 2016; 12(3): 366–368, doi: 10.1007/s12024-016-9788-7.
Zanetti P.P., Krasoń M., Walas R., Cebotaru T., Popa C., Vintila B., Steiu F. „Open” repair of ruptured thoracoabdominal aortic aneurysm (experience of 51 cases). Kardiochir. Torakochir. Pol. 2015; 12(2): 119–125, doi: 10.5114/kitp.2015.52852.
Skórski M., Brzeziński T., Szostek M., Ostrowski T., Macioch W. Fulminant course of visceral malperfusion due to type B aortic dissection. Acta Angiol. 2014; 20(1): 19–24.
Dziekiewicz M., Maciag R., Maruszynski M. New surgical modification of fascial closure following endovascular aortic pathology repair. Wideochir. Inne Tech. Maloinwazyjne 2014; 9(1): 89–92, doi: 10.5114/wiitm.2011.35795.
Patterson B.O., Sobocinski J., Karthikesalingam A., Hinchliffe R.J., Loftus I., Thompson M.M., Holt P.J. Expansion rate of descending thoracic aortic aneurysms. Br. J. Surg. 2016; 103(13): 1823–1827, doi: 10.1002/bjs.10299.