JUAN CRESTANELLO: Hi, I'm Dr. Juan Crestanello. Welcome to the Cardiovascular Surgery Series where I review the latest research in cardiovascular surgery from the Mayo Clinic in just two minutes.

I will discuss today differential expansion and outcomes of ascending and descending degenerative thoracic aortic aneurysms. In this study, we identified 137 patients from the Rochester Epidemiological Project who had degenerative thoracic aortic aneurysms and at least two CTs during the study period at least six months apart.

Seventy-eight patients had aneurysms in the ascending aorta, and 59 had it in the descending aorta. The baseline diameter was 48 millimeters for the ascending aorta and 42 millimeters for the descending aorta.

Patients with descending aneurysms were older and sicker. The expansion rate was 0.2 millimeters per year for the ascending aortic aneurysms and two millimeters per year for patients with descending thoracic aortic aneurysms. Factors associated with expansion were aneurysms of the descending aorta and larger baseline diameter.

Patients with descending aortic aneurysms had worse long-term survival. However, they were also older. Age and COPD were independently associated with mortality but not location or aneurysm size. Only 11% of the deaths were aortic-related and 28% of the deaths were related to cardiovascular causes.

Aortic-related events occurs in two patients in the ascending aorta and in 14 patients in the descending aorta. There were 10 aortic-related deaths. The events in the ascending aorta were two aortic dissections. The events in the descending aorta where eight aortic ruptures.

Freedom from aortic-related events occurs at five years in 98% of the ascending aortic patient and in 89% of the descending aortic group.

We conclude that degenerative thoracic aortic aneurysms expand slowly. Descending thoracic aortic aneurysms, a larger baseline diameter were associated with rapid expansion. Descending thoracic aortic aneurysms were associated with increased aortic-related events.

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