The New Dimension in Aortic Measurements - Use of the Inner Edge Measurement for the Thoracic Aorta in Australian Patients

Abstract

Historically, aortic measurements were established using M-mode echocardiography, measuring from the leading edge to leading edge. Improvements in echocardiographic imaging now permit accurate assessment using the blood-tissue interface. Normal values have not been established using this technique. A prospective analysis of consecutive patients without pathology was conducted. Measurements of aortic dimensions were made using the blood-tissue interface and the leading edge methods at end-diastole, and at end-systole using the blood-tissue interface. Data collected included BSA, and aortic measurements (LVOT, root, ST junction, mid ascending aorta, aortic arch). The echocardiograms of 512 patients were evaluated. The mean age was 56 years, with 304 males (59%) and 208 females (41%). The average measurements (blood tissue interface) were: aortic root 31.2mm, sinotubular junction 25.9mm, mid ascending aorta 30.6 and aortic arch 23.4. On average, the leading edge method measurements were 1.5mm larger (p<0.0001), consistent with the added thickness of the anterior aortic wall. Ratios to BSA were also estimated. Tables have been created suggesting normal and abnormal values. Improvements in echocardiographic imaging permit the blood-tissue interface to be readily visualised. Reference ranges for the estimation of aortic sizes using this method are provided. More accurate and anatomical estimation of the aortic dimensions can now be achieved.