50
Treatment
6.5.3.1. Size Thresholds for Repair of Descending TAA
COR LOE
Recommendations
1 B-NR 1. In patients with intact descending TAA, repair is
recommended when the diameter is ≥5.5 cm.
2b B-NR 2. In patients with intact descending TAA and risk factors for
rupture (Table 17), repair may be considered at a diameter of
<5.5 cm.
2b B-NR 3. In patients at increased risk for perioperative morbidity and
mortality (Table 18), it may be reasonable to increase the size
threshold for surgery accordingly.
Table 16. Adverse Aortic Events at 1 Year, Based on Baseline
Aortic Diameter, Among Patients With Descending
TAA
Aortic Diameter (cm) Definite Aortic Event* (%) Probable Aortic Event
†
5.0 5.5 8.0
5.5 7.2 11.2
6.0 9.3 15.6
7.0 15.4 28.1
* Definite aortic event includes aortic dissection or rupture confirmed with imaging or
intraoperative findings.
†
Probable aortic event includes definite aortic events as well as sudden unexplained death.
Based on data from Kim JB, et al. J orac Cardiovasc Surg. 2014;147:1505-1510.
Table 17. Risk Factors for Aortic Rupture Among Patients
With Descending TAA
High-Risk Features for Rupture
Aneurysm growth of ≥0.5 cm/y
Symptomatic aneurysm
Marfan, Loeys-Dietz, or vascular Ehlers-Danlos syndrome, or HTAD
(please see section 6.1.2)
Saccular aneurysm
Female sex
Infectious aneurysm
