Un paciente me pide que le informe de su dilatacion raiz aortica y el seguimiento por cardio

Inicio busqueda para respuesta:

Encuentro en uptodate 

"Cuando se detecta dilatación aórtica, se realizan ecocardiografías seriadas de la aorta para asegurar su estabilidad. Es frecuente realizar estudios de imagen de seguimiento un año después del diagnóstico inicial. Si la evaluación clínica del paciente y el diámetro aórtico son estables, pueden ser apropiados intervalos más largos, especialmente si el diámetro es inferior a 4,5 cm [11]. Se suele realizar al menos una TC o una RM para verificar que el diámetro máximo de la aorta ascendente pueda visualizarse mediante ecocardiografía. Los diámetros aórticos superiores a 4,5 cm presentan un mayor riesgo de eventos y deben ser monitoreados con mayor atención [2]."

 en un paper

https://www.elsevier.es/es-revista-cirugia-cardiovascular-358-articulo-aportacion-ecocardiografia-valoracion-enfermedad-aortica-S1134009609701299

y una guia

Echocardiography in aortic diseases: EAE recommendations for clinical practice

https://www.escardio.org/static-file/Escardio/Subspecialty/EACVI/position-papers/EAE-recommendation-aortic-diseases.pdf#:~:text=La%20dilataci%C3%B3n%20de%20la%20ra%C3%ADz%20a%C3%B3rtica%20en,rango%20normal%20superior%20en%20la%20aorta%20ascendente.

En este articulo recomienda seguimiento entre 1-3 años dependiendo de severidad.

Follow-up of incidentally detected mild to moderate ascending aortic dilation and risk factors for rapid progression in a Swedish middle-aged population

https://pmc.ncbi.nlm.nih.gov/articles/PMC12505057/#:~:text=The%20recently%20published%20guidelines%20from,for%20progression%20of%20aortic%20dilation.

The recently published guidelines from 2024, however, suggest that follow-up imaging should be performed every 6–36 months depending on the degree of aortic dilation. The American guidelines6 from 2022 recommend surveillance imaging every 6–24 months.

An efficient follow-up strategy is indeed needed, particularly in individuals with mild to moderate ascending aorta dilation, not least to prevent excessive healthcare expenditures and to reduce radiation exposure. It seems that less dilated ascending aortas have generally slow progression rate,3 7 but these findings are mostly based on retrospective studies in selected cohorts. Thus, there is a lack of well-designed, prospective and general population-based studies that investigate progression of ascending aorta dilation and risk factors for dilation progression. In the ASCending Aorta study (ASCA), we prospectively follow subjects with dilated ascending aortas identified within the general population-based Swedish CArdioPulmonary bioImage study (SCAPIS).

The aim of this specific study was to describe the natural history of sporadically discovered, mildly to moderately dilated ascending aortas and to determine risk factors for progression of aortic dilation.

Parece que el seguimiento que ha propuesto cardio de 2 años no es excesivo. Tranquilizaremos al paciente.