Case Report
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World J Cardiol. May 26, 2014; 6(5): 349-352
Published online May 26, 2014. doi: 10.4330/wjc.v6.i5.349
Unreliability of aortic size index to predict risk of aortic dissection in a patient with Turner syndrome
Jan Nijs, Sandro Gelsomino, Fabiana Lucà, Orlando Parise, Jos G Maessen, Mark La Meir
Jan Nijs, Mark La Meir, Cardiothoracic Surgery, University Hospital, 1090 Brussels, Belgium
Sandro Gelsomino, Fabiana Lucà, Orlando Parise, Jos G Maessen, Cardiothoracic Department, Maastricht University Hospital, 6229 HX Maastricht, The Netherlands
Author contributions: Nijs J and Gelsomino S conceived and drafted the article; Parise O and Lucà F contributed to the imaging and revised the manuscript for important intellectual contents; Maessen JG and La Meir M approved the final version of the manuscript to be published.
Correspondence to: Sandro Gelsomino, MD, PhD, Cardiothoracic Department, Maastricht University Hospital, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands. sandro.gelsomino@libero.it
Telephone: +31-43-3877070 Fax: +31-43-3875075
Received: December 31, 2013
Revised: March 11, 2014
Accepted: March 17, 2014
Published online: May 26, 2014
Processing time: 171 Days and 14.7 Hours
Abstract

Aortic size index (ASI) has been proposed as a reliable criterion to predict risk for aortic dissection in Turner syndrome with significant thresholds of 20-25 mm/m2. We report a case of aortic arch dissection in a patient with Turner syndrome who, from the ASI thresholds proposed, was deemed to be at low risk of aortic dissection or rupture and was not eligible for prophylactic surgery. This case report strongly supports careful monitoring and surgical evaluation even when the ASI is < 20 mm/m2 if other significant risk factors are present.

Keywords: Aortic dissection; Aortic aneurysm; Turner syndrome

Core tip: Aortic size index (ASI) has been proposed as a reliable criterion to predict risk of aortic dissection in Turner syndrome. This case report emphasizes the need for careful monitoring and surgical evaluation of the patients even when the ASI is < 20 mm/m2 if other significant risk factors are present.