Assessing Effectiveness of Follow-Up CT for Dilated Aortas in Simulated Cohort

Background: Dilatation of the ascending aorta with a diameter ≥40 mm is a relatively common incidental finding in patients undergoing chest CT. The American College of Radiology defines ascending aortic aneurysm as ≥50 mm, while some cardiology references use 40 mm as the cutoff. Surgical repair is indicated for aortas ≥55 mm, growing more than 5 mm per year, and aortas ≥45 mm in patients undergoing aortic valve surgery (with patients with genetic or bicuspid valve aortopathy generally have a lower threshold) per guidelines from the American Heart Association. Patients with aortas larger than these thresholds are considered to have ascending aortic aneurysms and are at increased risk for dissection and rupture. Dilated ascending aortas grow slowly over time but there are no consensus guidelines to indicate frequency of CT follow-up. Objective: To evaluate the cost-effectiveness of CT follow-up approach for incidental aortic dilatation. Methods: This cost-effectiveness ana more...