Advances in surgical thresholds for ascending aortic aneurysms: an expert perspective

Abstract

The ascending aortic aneurysm represents a critical clinical concern due to its potential for catastrophic complications. With global demographic shifts toward aging populations, the incidence of ascending aortic aneurysms is projected to rise significantly. This brief perspective examines the evolution of our understanding regarding the natural history of ascending aortic aneurysms and the refinement of surgical intervention criteria over time. We discuss the transition from simplistic diameter-based metrics to multidimensional assessment approaches that consider patient-specific factors, including anatomical variations, biomechanical properties, and genetic predispositions. Recent paradigm shifts, such as the recalibration of diameter thresholds from 5.5 cm to 5.0 cm and the integration of volumetric analysis, highlight the field's progression toward more precise risk stratification. This paper aims to provide clinicians with a contemporary framework for surgical decision-making while identifying promising avenues for further refinement of intervention strategies.

Keywords

Aortic aneurysm / surgical indicator / natural history

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