Annuloaortic ectasia

Annuloaortic ectasia
Other namesCystic medial necrosis of aorta[1]
Segments of the aorta, including the thoracic aorta, ascending aorta, aortic arch, descending thoracic aorta, abdominal aorta, suprarenal abdominal aorta, and infrarenal abdominal aorta.
SpecialtyCardiology

Annuloaortic ectasia is characterized by pure aortic valve regurgitation and aneurysmal dilatation of the ascending aorta.[2] Men are more likely than women to develop idiopathic annuloaortic ectasia, which usually manifests in the fourth or sixth decades of life. Additional factors that contribute to this condition include osteogenesis imperfecta, inflammatory aortic diseases, intrinsic valve disease, Loeys-Dietz syndrome, Marfan syndrome, and operated congenital heart disease.[3]

On a gross level, there is a pear-shaped, symmetric enlargement due to proximal aortic dilation. The aortic wall dilatation at the commissural level causes the cusps to effectively shorten and prevent them from converging during systole, which results in aortic valve incompetence. The arch is typically spared from the aneurysmal process, though it may involve the entire ascending aorta. The ectatic aorta may experience dissections. Dissections of the ascending aorta are typically tiny, confined, and restricted. Aortic rupture can happen even if there is no dissection.[3]

The term was first coined by the American heart surgeon Denton Cooley in 1961.[4]

  1. ^ "Orphanet: Familial aortic dissection". Orpha.net. Retrieved 29 May 2019.
  2. ^ An, Zhao; Xu, Zhi-Yun; Poullis, Mike; Tang, Paul C.; Oliveira, Nilto De; Rylski, Bartosz; Milewski, Rita K.; Urbanski, Paul P.; Diegeler, Anno; Kumar, Neeraj; Yang, Laurence T. (December 1, 2004). "Aortic valve sparing operations: basic concepts". International Journal of Cardiology. 97. Elsevier: 61–66. doi:10.1016/j.ijcard.2004.08.010. ISSN 0167-5273. PMID 15590080. Retrieved December 29, 2023.
  3. ^ a b Kinoshita, Ryoji; Arai, Hirokuni; Barillà, David; Benedetto, Filippo; Ladich, E.; Virmani, R.; Seidman, M.A.; McManus, B.M.; Subbotin, Vladimir M.; Spanos, K.; Giannoukas, A.D. (January 1, 2016). Vascular Pathobiology: Atherosclerosis and Large Vessel Disease. Academic Press. pp. 85–124. doi:10.1016/B978-0-12-420219-1.00003-3. ISBN 9780124202191. Retrieved December 29, 2023.
  4. ^ Kaiser, Larry; Kron, Irving L.; Spray, Thomas L. (2013-12-24). Mastery of Cardiothoracic Surgery. Lippincott Williams & Wilkins. ISBN 9781451113150.