Moderate aortic enlargement and bicuspid aortic valve are associated with aortic dissection in turner syndrome

Report of the international turner syndrome aortic dissection registry

Misty Carlson, Nathan Airhart, Leo Lopez, Gary (Michael) Silberbach

Research output: Contribution to journalArticle

83 Citations (Scopus)

Abstract

Background-Girls and women with Turner syndrome are at risk for aortic dissection and rupture. However, the size of the aorta and the clinical characteristics among those with Turner syndrome and dissection have received little attention. Methods and Results-We obtained medical records from 20 individuals who voluntarily participated in the International Turner Syndrome Aortic Dissection Registry. Type A dissections occurred in 17 of 20 (85%) cases, and type B occurred in 3 cases of which 1 occurred after coarctation stent placement. Of those with spontaneous aortic dissections, 18 of 19 (95%) had an associated cardiac malformation that included a bicuspid aortic valve. In 1 individual there was no predisposing finding other than the presence of Turner syndrome. Associated pregnancy was documented in 1 of 19 (5%). More than half (13/19, 68%) came to medical attention >24 hours after the onset of symptoms. For those with type A dissections, the mean ascending aortic size index was 2.7±0.6 cm/m (n=9). Conclusions-Aortic dissection in Turner syndrome occurs in young individuals at smaller aortic diameters than in the general population or other forms of genetically triggered aortopathy. The absence of aortic valve or other cardiac malformations appears to markedly reduce the risk of aortic dissection However, aortic dissection can occur in Turner syndrome without cardiac malformations or hypertension. Individuals with Turner syndrome who are >18 years of age with an ascending aortic size index >2.5 cm/m should be considered for an aortic operation to prevent aortic dissection.

Original languageEnglish (US)
Pages (from-to)2220-2226
Number of pages7
JournalCirculation
Volume126
Issue number18
DOIs
StatePublished - Oct 30 2012

Fingerprint

Turner Syndrome
Registries
Dissection
Bicuspid Aortic Valve
Aortic Rupture
Aortic Valve
Stents
Medical Records
Aorta
Hypertension
Pregnancy

Keywords

  • aneurysm
  • aorta
  • Turner syndrome

ASJC Scopus subject areas

  • Physiology (medical)
  • Cardiology and Cardiovascular Medicine

Cite this

Moderate aortic enlargement and bicuspid aortic valve are associated with aortic dissection in turner syndrome : Report of the international turner syndrome aortic dissection registry. / Carlson, Misty; Airhart, Nathan; Lopez, Leo; Silberbach, Gary (Michael).

In: Circulation, Vol. 126, No. 18, 30.10.2012, p. 2220-2226.

Research output: Contribution to journalArticle

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abstract = "Background-Girls and women with Turner syndrome are at risk for aortic dissection and rupture. However, the size of the aorta and the clinical characteristics among those with Turner syndrome and dissection have received little attention. Methods and Results-We obtained medical records from 20 individuals who voluntarily participated in the International Turner Syndrome Aortic Dissection Registry. Type A dissections occurred in 17 of 20 (85{\%}) cases, and type B occurred in 3 cases of which 1 occurred after coarctation stent placement. Of those with spontaneous aortic dissections, 18 of 19 (95{\%}) had an associated cardiac malformation that included a bicuspid aortic valve. In 1 individual there was no predisposing finding other than the presence of Turner syndrome. Associated pregnancy was documented in 1 of 19 (5{\%}). More than half (13/19, 68{\%}) came to medical attention >24 hours after the onset of symptoms. For those with type A dissections, the mean ascending aortic size index was 2.7±0.6 cm/m (n=9). Conclusions-Aortic dissection in Turner syndrome occurs in young individuals at smaller aortic diameters than in the general population or other forms of genetically triggered aortopathy. The absence of aortic valve or other cardiac malformations appears to markedly reduce the risk of aortic dissection However, aortic dissection can occur in Turner syndrome without cardiac malformations or hypertension. Individuals with Turner syndrome who are >18 years of age with an ascending aortic size index >2.5 cm/m should be considered for an aortic operation to prevent aortic dissection.",
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