Anuloaortic ectasia: A clinical and echocardiographic study

Twenty-six patients with an aortic root diameter ≥ 3.7 cm by 2-dimensional echocardiography (2-D echo) were studied. Group I consisted of 14 patients (mean age 50 ± 14 years) with idiopathic anuloaortic ectasia and group II consisted of 12 patients (mean age 60 ± 12 years) with secondary causes of aortic root dilatation. Patients in group I had a significantly larger aortic root diameter at the level of the aortic valve (5.0 ± 0.7 cm) and 2 cm above the aortic valve (5.3 ± 1.2 cm) as assessed by echo than did patients in group II (4.1 ± 0.3 and 4.4 ± 0.4 cm, respectively, p < 0.025). The diameter of descending thoracic aorta was slightly larger in patients in group II (3.1 ± 0.8 vs 2.7 ± 0.5 cm, difference not significant). Over a mean follow-up period of 18 months, in group I, aortic dissection developed in 3 patients and severe aortic regurgitation and congestive heart failure in 2; 7 patients had aortic root grafting, aortic valve replacement or both. The 3 patients in group I with aortic dissection had an aortic root diameter ≥ 5.3 cm, but 4 asymptomatic patients also had a diameter > 5 cm. Only 1 patient in group II required surgery for aortic dissection. Thus, 2-D echo is useful in identifying and following high-risk patients with anuloaortic ectasia.