Growth rates in non-syndromic aneurysms of the ascending aorta: a systematic review

The maximum aortic diameter is the main risk predictor for type A acute aortic syndromes and understanding the growth rate of ascending thoracic aortic aneurysms (aTAAs) is pivotal for risk assessment and stratification for pre-emptive aortic surgery. Prevailing guidelines recommend serial imaging of aTAA patients until the thresholds for prophylactic surgery are met. Based on early landmark studies, it was thought that the growth rate of aTAAs is substantially higher than that of the normal-sized aorta. However, more recent studies have reported that aTAA growth is generally slow, questioning the need for frequent imaging during follow-up. The current systematic review provides an overview of studies reporting annual diameter growth rates of non-syndromic aTAAs and explains differences in findings between early and recent studies.