In coarctation of the aorta, what measurement indicates a high risk of dissection?

In cases of coarctation of the aorta, the measurement that serves as a critical marker for the risk of dissection is the diameter index. This measurement assesses the size of the aorta relative to the body surface area, which is a key factor in determining the likelihood of complications, including dissection.

A diameter index greater than 27 mm/m² indicates a significantly increased risk of aortic dissection. This threshold recognizes that larger aortic diameters, especially in the context of coarctation, may lead to elevated pressures and stress on the aortic wall, making it more susceptible to tearing or other forms of catastrophic failure. Therefore, when evaluating patients with coarctation, monitoring for dimensions that exceed this measurement becomes essential in assessing their risk for life-threatening complications.

The other measurements, while relevant in various clinical settings, do not correlate with the same level of risk for dissection associated with coarctation of the aorta. Thus, recognizing a diameter index over 27 mm/m² is crucial for proper management and preemptive intervention in affected patients.