In Vivo Evaluation of Growth and Risk of Rupture of Dilated Ascending Aorta Using 4D Cardiac Magnetic Resonance
In Vivo Evaluation of Growth and Risk of Rupture of Dilated Ascending Aorta Using 4D Cardiac Magnetic Resonance
Ascending aorta aneurysmal disease is common and can be complicated by dissection or rupture.
 There is substantial variation in individual aneurysm progression: established risk factors
 for an accelerated aneurysm growth rate include initial size or localization, the presence of
 aortic valve disease, congenital bicuspid aortic valve or connective tissue disorders.
Although there is an increased lifetime risk when the aortic diameter exceeds 6 cm,
 predicting aneurysm progression is nearly impossible and dissection and rupture also occur at
 diameters under 6 cm. The assessment of aortic hemodynamics and the presence of altered flow
 patterns, as well as distribution and changes in wall shear stress (WSS) and the oscillatory
 shear index (OSI), using 4D phase contrast cardiovascular magnetic resonance (CMR) may
 provide further insights in how aneurysms develop and in assessing the risk of dissection.
 The purpose of this study was to investigate in patients with dilated ascending aorta the
 flow patterns and vessel wall parameters in order to correlate these hemodynamics factors
 with changes in aorta size.
Inclusion Criteria:

 -  Age ≥ 18 years.

 -  Supra-coronary aortic diameter measured by CT-scan or transthoracic/trans-esophageal
 echocardiography between 40 and 45 mm in case of presence of aortic valve disease,
 bicuspid aortic valve or connective tissue disease and between 40 and 50 mm in case of
 absence of aortic valve disease, bicuspid aortic valve disease or connective tissue.

 -  Informed consent for participation in the study

 Exclusion Criteria:

 -  Contraindication to MRI

 -  Patient's refusal to participate in the study and / or inability to express agreement
 or signing the informed consent.