Objective

The predissection aortic diameter is the best reference for determining the size of the frozen elephant trunk in aortic dissection. We aimed to develop a new prediction method to estimate the predissection diameter of proximal descending aorta. Furthermore, we evaluated the accuracy of the estimated predissection proximal descending aortic diameters calculated using three prediction methods.

Methods

A total of 39 patients with acute type A aortic dissection who underwent predissection computed tomography were included in derivation sets. We measured the aortic dimensions at three levels of the proximal descending aorta: 5, 10, and 15 cm from zone 2. We developed a new prediction method—postdissection aortic diameter divided by 1.13 (AoD_{New factor}) — and estimated the predissection aortic diameter using the new and previously proposed methods by Rylski (AoD_Rylski) and Yamauchi (Equation_Yamauchi). Furthermore, we validated the new prediction method using a validation dataset with 24 patients.

Results

The rate of bias ≤ 2 mm was significantly higher with Equation_Yamauchi and AoD_{New factor} than with AoD_Rylski in the derivation group at each level of the proximal descending aorta (P < 0.001). In the validation group, the rate of bias ≤ 2 mm was significantly higher with Equation_Yamauchi and AoD_{New factor} than with AoD_Rylski at 10 cm and 15 cm from zone 2 (10 cm: P = 0.014, 15 cm: P < 0.001).

Conclusions

These results suggest that the new prediction method can be used as a simple and accurate estimation method for the predissection aortic diameter at the proximal descending aorta.

中文翻译：

---

冷冻象鼻的适当尺寸：如何在解剖前预测近端降主动脉直径？

客观的

夹层前的主动脉内径是确定主动脉夹层冷冻象鼻尺寸的最佳参考。我们的目的是开发一种新的预测方法来估计近端降主动脉的预夹层直径。此外，我们评估了使用三种预测方法计算的估计预夹层近端降主动脉直径的准确性。

方法

派生组中总共包括 39 名接受夹层前计算机断层扫描的急性 A 型主动脉夹层患者。我们测量了近端降主动脉三个水平的主动脉尺寸：距区域 2 5、10 和 15 厘米。我们开发了一种新的预测方法——夹层后主动脉直径除以 1.13（AoD_新因子）——并估计夹层前主动脉直径使用 Rylski (AoD _Rylski ) 和 Yamauchi (Equation _Yamauchi )先前提出的新方法。此外，我们使用 24 名患者的验证数据集验证了新的预测方法。

结果

在近降主动脉各节段的推导组中， Equation _Yamauchi和 AoD _{New 因子}的偏倚率 ≤ 2 mm 显着高于AoD _{Rylski （} P < 0.001）。在验证组中，距离 2 区 10 cm 和 15 cm 时，使用 Equation _Yamauchi和 AoD _{New 因子}的偏倚率 ≤ 2 mm 显着高于使用AoD _{Rylski的偏倚率（10 cm：} P = 0.014，15 cm：P < 0.001） 。

结论

这些结果表明，新的预测方法可以用作近端降主动脉夹层前主动脉直径的简单而准确的估计方法。