Aorta

Question 1

Degenerative ascending aortic aneurysm surveillance

Answer 1

3. 5-4.5 cm annual

4. 5-5.4 cm biannual

Question 2

Genetic TAA surveillance

Answer 2

3. 5-4.0 annual

4. 0-5.0 biannual

Question 3

Descending aorta aneurysm surveillance

Answer 3

4. 0-5.0 annual (CT/MRA)

5. 0-6.0 biannual (CT/MRA)

Question 4

TAA indications for repair

Answer 4

Symptoms or rupture
Size
Rapid enlargement
Traumatic
Infectious
AVR if ascending aorta > 4.5

Question 5

Size for repair for ascending TAA

Answer 5

Diameter > 5.5 cm or index >= 2.75

>4.5 cm genetic

Question 6

Size for repair for descending TAA

Answer 6

> 5.5 cm

>5.0 cm genetic

Question 7

TAA rapid enlargement

Answer 7

> = 10 mm/yr

>5 mm/yr in genetic

Question 8

Indication for repair for AAA

Answer 8

Symptoms
rupture 
> 5.5 cm
Rapid expansion
Inflammatory or infectious

Question 9

Screening for AAA

Answer 9

Men 65-75 who smoked

Men >= 60 with 1st deg relative with AAA

Question 10

Complex plaque in aorta

Answer 10

Increased risk of embolism
>4 mm width
Mobile at any size
Ulcerated

Question 11

Penetrating aortic ulcer

Answer 11

Similar to dissection
Echolucent intramural hematoma overlying atherosclerosis
Increase wall thickness
No intimal flap

Question 12

Aortic intramural hematoma

Answer 12

Similar to dissection
No intimal tear
Layered thickened, crescentic hematoma

Question 13

BAV cut off for surgery

Answer 13

55 mm

Question 14

BAV higher risk features

Answer 14

50 mm
FH of dissection
>3 mm/year dilatation
Uncontrolled HTN
Root phenotype
Coarctation

Question 15

Marfan surgery cutoff

Answer 15

50 mm

Question 16

Ascending aorta measurement in kids

Answer 16

Inner edge to inner edge in systole

Question 17

Ascending aorta measurement in adults

Answer 17

Leading edge to leading edge end-diastolic

Question 18

Bovine aortic arch

Answer 18

Innominate artery and left common carotid artery have a common origin
9-13% of individuals
Imaged from suprasternal notch

Question 19

Complex aortic atheroma most likely to occur in

Answer 19

Descending aorta

Question 20

Traumatic aortic deceleration injury most common finding

Answer 20

Localized thick flap in region of aortic isthmus

Question 21

Aortic aneurysm definition

Answer 21

Aortic dilatation to at least 1.5x expected normal diameter

Question 22

Marfan aorta

Answer 22

Aneurysm of ascending aorta involving at least the sinuses of valsalva (most common site)
Descending thoracic and thorax-abdominal aorta are also common

Question 23

Mirror image right sided aortic arches

Answer 23

Innominate artery originates as first branch, then right carotid, then right subclavian
A/w ToF

Question 24

Non-mirror image R sided aortic arch

Answer 24

Left carotid artery, right carotid artery, right subclavian, left subclavian
Left subclavian originates from proximal descending aorta with prominent diverticulum of Kommerall

Question 25

Shone complex

Answer 25

Supravalvular mitral ring Parachute-like mitral valve Subaortic stenosis Aortic coarctation

Question 26

Turner syndrome a/w

Answer 26

Coarctation BAV Aneurysm / dissection

Question 27

Noonan syndrome a/w

Answer 27

Pulmonary stenosis | HCM

Question 28

BAV associated with

Answer 28

Ascending aortic dilatation in >50% Most often tubular ascending aorta Coarctation ~5%

Question 29

DeBakey 1

Answer 29

Ascending aorta, arch +/- descending

Question 30

DeBakey II

Answer 30

ascending aorta only

Question 31

DeBakey IIIa

Answer 31

Descending aorta above diaphragm

Question 32

Debakey IIIb

Answer 32

Descending aorta below diaphragm

Question 33

Grade 1 aortic atheroma

Answer 33

Thickness <2mm | Normal intimal thickening

Question 34

Grade II atheroma

Answer 34

Mild intimal thickening 2-3 mm

Question 35

Grade III atheroma

Answer 35

Moderate intimal thickening | >3-5 mm

Question 36

Grade IV atheroma

Answer 36

Severe thickening | >5mm

Question 37

Grade V atheroma

Answer 37

Complex atheroma | Grade 2-4 + mobile or ulcerated components

Question 38

Aortic doppler in coaractation

Answer 38

Typically overestimates peak gradient due to elevated pre-coaractation velocity

Question 39

Quadricuspid AV associated with

Answer 39

Severe AR | Not aortic conditions

Question 40

Best view for ascending aorta

Answer 40

Parasternal window | Move up an interspace, medial toward sternum

Question 41

Hemodynamically significant PDA

Answer 41

Left sided volume overload | Pulmonary hypertension

Question 42

Abdominal aorta doppler coarctation

Answer 42

Low velocity systolic velocity Higher-velocity diastolic forward flow Decreased pulsatility Delay in systolic peak velocity

Question 43

Thickening of aortic-mitral curtain

Answer 43

Aortitis | Endocarditis with abscess