P043. Aortic Dimensions in Asian Population – Deciphering the Aorta Size Paradox
Nepal Mediciti
Kathmandu
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Dr Bijoy G Rajbanshi is a Cardiovascular Surgeon and is the Principal Consultant and Head, Department of Cardio Vascular and Thoracic Surgery at Nepal Mediciti in Lalitpur, Nepal.
He has done his Bachelor of Medicine and Surgery from Jawarlal Nehru Medical College in India, MS in Cardiovascular and Thoracic Surgery from National Institute of Cardio Vascular Disease, BSM Medical University, Bangladesh. He has done his Clinical Fellowship in Cardiac Surgery from Mayo Clinic, Rochester, Minnesota, USA and Advanced Clinical Fellowship in Adult Cardiac Surgery from Yale University School of Medicine at New Haven, Connecticut, USA.
He is the immediate Past President of Cardiac Society of Nepal, which is the largest orgaization of medial professionals that are involved with cardiovascular diseases in the country and is presently a Council member of Association of Thoracic and Cardiovascular Surgeons of Asia. He has previously served as the Vice President of Asia Pacific Society of Cardiology, and a Council Member of Asian Heart Society.
He has a work experience of over 20 years. He has written multiple publications in International and National journals including chapters in textbook.
His special interest includes Adult Cardiac Surgery, Surgery for various Aortic diseases in adults, children and infants, Hypertrophic Cardiomyopathy.
Description
Methods: Seven hundred and four patients admitted to our center due to polytrauma between January 2018 to December 2022 underwent protocolized non-contrast cardiac CT of the chest and abdomen. Images were used to measure the diameter of the aorta at the established reference levels. Patients below 18 years of age(N=50), individuals not confirming Asian ethnicity(N=6), and patients with images with excessive motion artifacts resulting in difficulty in assessing their diameters(N=135) were excluded.
Results: There were 513 patients with a mean age of 34.7+14.6 (range 18-86) and 382 (74.5%) males. The dimensions of the aorta at sinus, ascending aorta, arch, descending aorta, supra and infrarenal aorta were 30.7 + 3.8, 29.3 + 4.5, 24.9 + 3.3, 20.1 + 3.0, 19.4 + 2.9 and 15.3 + 2.2 respectively. The age of patients demonstrated a positive correlation to the diameter at the ascending aorta, descending aorta, and infrarenal aorta {(r=0.58, p<0.01 [CI95%. 0.519; 0.634]; r=0.69, p<0.01 [CI 0.642; 0.733]; r=0.571, p<0.01 [CI 0.509; 0.626])} along with the length of the ascending aorta to the above reference diameters {(r=0.420, p < 0.01 [CI95% = 0.346; 0.488]; (r = 0.536, p < 0.01; [CI95% = 0.47; 0.595]; (r = 0.476, p < 0.01; [CI95% = 0.407; 0.541]} respectively. Females had a smaller dimension of the aorta at the majority of reference points without any statistical significance. There were 50 (9.8%) patients with bovine aortic arch and 10 (1.9%) patients with separate origin of vertebral artery from the arch of the aorta. The dimension of the distal descending aorta, suprarenal, and infrarenal abdominal aorta appears markedly smaller in our population compared to what is elucidated in literature amongst the Western population.
Conclusion: Normal values of the diameter of the aorta are provided and are affected by age and length of the ascending aorta. The study suggest that the aorta size is much smaller in Asians, more significantly for distal descending and abdominal aorta, and that ethnicity may have a prominent role in determining indication for intervention.
Authors
Bijoy Rajbanshi (1), Bhuwan Kayastha (2), Gangaram Biswakarma (3), Sangam KC (4), Pralaya Khadka (4), Dharmendra Joshi (5), Ram Kumar Ghimire (2)
Institutions
(1) Department of Cardio Vascular and Thoracic Surgery, Nepal Mediciti, Nepal, (2) Department of Radiology, Nepal Mediciti, Lalitpur, Bagmati, (3) Tribhuwan University, Kathmandu, Bagmati, (4) Nepal Mediciti, Lalitpur, NA, (5) Department of Cardio Vascular and Thoracic Surgery, Nepal Mediciti, Lalitpur, Bagmati