Ascending aorta measurements as assessed by ECG-gated multi-detector computed tomography: a pilot study to establish normative values for transcatheter therapies

The aim of this study was to provide an insight into normative values of the ascending aorta in regards to novel endovascular procedures using ECG-gated multi-detector CT angiography. Seventy-seven adult patients without ascending aortic abnormalities were evaluated. Measurements at relevant levels of the aortic root and ascending aorta were obtained. Diameter variations of the ascending aorta during cardiac cycle were also considered. Mean diameters (mm) were as follows: LV outflow tract 20.3 ± 3.4, coronary sinus 34.2 ± 4.1, sino-tubular junction 29.7 ± 3.4 and mid ascending aorta 32.7 ± 3.8 with coefficients of variation (CV) ranging from 12 to 17%. Mean distances (mm) were: from the plane passing through the proximal insertions of the aortic valve cusps to the right brachio-cephalic artery (BCA) 92.6 ± 11.8, from the plane passing through the proximal insertions of the aortic valve cusps to the proximal coronary ostium 12.1 ± 3.7, and between both coronary ostia 7.2 ± 3.1, minimal arc of the ascending aorta from left coronary ostium to right BCA 52.9 ± 9.5, and the fibrous continuity between the aortic valve and the anterior leaflet of the mitral valve 14.6 ± 3.3, CV 13–43%. Mean aortic valve area was 582.0 ± 131.9 mm². The variation of the antero-posterior and transverse diameters of the ascending aorta during the cardiac cycle were 8.4% and 7.3%, respectively. Results showed large inter-individual variations in diameters and distances but with limited intra-individual variations during the cardiac cycle. A personalized approach for planning endovascular devices must be considered.