TY  - EJOU
AU  - Bons, Lidia R. 
AU  - Assis, Lucas Uchoa de 
AU  - Dekker, Silvy 
AU  - Kauling, Robert M. 
AU  - Cuypers, Judith A.A.E. 
AU  - Verhagen, Hence J.M. 
AU  - Budde, Ricardo P.J. 
AU  - Roos‐Hesselink, Jolien W. 

TI  - Screening for thoracic aortic pathology: Clinical practice in a single tertiary center
T2  - Structural and Congenital Heart Disease

PY  - 2018
VL  - 13
IS  - 6
SN  - 3071-1738

AB  - <b>Objective:</b> The aim is to present current clinical practice of thoracic aorta screening in 
a tertiary referral center. We identified how often imaging techniques were used for 
screening and established the value of transthoracic echocardiography (TTE) in com‐
parison with computed tomography (CT) to detect aortic dilation. We also investigated 
which additional abnormalities of the heart, aorta or smaller arteries were discovered.<br/>
<b>Design:</b> All patients ≥15 years who visited our tertiary center in 2012‐2016 for first 
thoracic aortic screening were retrospectively included. Diameters of the sinus of 
Valsalva (SoV) and maximum ascending aorta (AA) were compared between TTE and 
CT. The sensitivity and specificity of TTE to detect aortic dilation (≥40 mm) was as‐
sessed with CT as reference standard. Intracardiac abnormalities found with TTE and 
arterial abnormalities found with CT were identified.<br/>
<b>Results:</b> In total 349 patients (155 men, age 41 ± 15 years, 10% genetic mutation) were 
included. Screening was performed with TTE only in 35% and with TTE and CT in 65%. 
Patients who underwent TTE only were younger, had less often hypertension and less 
often a family history of aortic pathology. Although there was a good correlation be‐
tween TTE and CT, the diameters measured with TTE were typically lower (SoV −1.0, 
95%CI −6.6 to 4.7 and AA −0.4, 95%CI −6.5 to 5.8). Sensitivity of TTE for detecting aortic 
dilation was 61% (SoV) and 57% (AA) and specificity was 96% (SoV) and 100% (AA). Valve 
abnormalities, ventricular dilation or reduced ventricular function was found with TTE in 
26 patients (7%). In 47 patients (13%) ascending aortic dilation was diagnosed and in 10 
patients (4%) relevant peripheral arterial abnormalities were identified using CT.<br/>
<b>Conclusions:</b> Most often patients received both TTE and CT (65%). Since TTE showed 
a low sensitivity to detect aortic dilation, CT imaging is advised at least once in pa‐
tients referred for thoracic aortic screening.
KW  - computed tomography
KW  -  echocardiography
KW  -  screening
KW  -  thoracic aortic pathology

DO  - 10.1111/chd.12663