Aortopathy: aortic aneurysm and dissection

At a glance

• Aortopathy covers aneurysm (permanent dilatation over 1.5 times normal) and the acute aortic syndromes: dissection, intramural haematoma (IMH) and penetrating atherosclerotic ulcer (PAU).
• Thoracic aneurysms are mostly degenerative or genetic; abdominal aneurysms (AAA) are mostly atherosclerotic and linked to smoking, age and male sex.
• Elective surgery is timed by diameter, growth rate and cause. The 2024 ESC guideline set the ascending aorta threshold at 55 mm for a tricuspid valve without a syndrome.