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Thoracic Aortic Aneurysm Screening Courtesy of COVID-19
Daniel Kaufman, Robert Y. Rhee, Benjamin A. Youdelman.
Maimonides Medical Center, Brooklyn, NY, USA.

OBJECTIVE: The COVID-19 pandemic presented an opportunity to review a large number of CT scans in a heterogenous urban population. Although these CT scans were obtained to evaluate and diagnose COVID lung pathology, review of the aorta in these patients gave us a unique opportunity to evaluate the incidence and significance of thoracic aortic aneurysms. Therefore, we set out to identify the incidence of thoracic aortic aneurysm in a population of patients being treated at a large tertiary care center during the COVID pandemic.METHODS: CT scans were reviewed by two cardiovascular surgeons and a radiologist in patients ages 18-75 who presented to the hospital due to COVID-19 symptoms during a 3 month period (February-April of 2020). Diameter was determined by the maximum span within the thoracic aorta. Aortic aneurysms were defined as a diameter of 4.1 cm or greater. Patients with previous cardiac or aortic surgery were excluded. All aortic enlargement was recorded from the aortic valve to the origin of the celiac artery. RESULTS: 1573 CT scans were analyzed during this time period. 14% (221) had aortic diameters over 4.1 cm. Aortic diameter of 4.5 cm or larger were identified in 4.8% (75) of patients.
CONCLUSIONS: The previously reported prevalence of thoracic aortic aneurysms has been less than 1%. Our study reveals a higher than expected prevalence of aneurysmal disease within the thoracic aorta than previously reported. Thoracic aortic aneurysm screening programs should be considered to identify patients at risk.


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