Aortic Risk Index Calculation Based on Body Surface Area and Surgical Indications for the Treatment of Ascending Aorta Expansive Anerurysms

Background and Aim: Surgical indications to aorta repair is based mainly on diameter of expansive aneurysm that correlates with aortic risk index calculated for patients’ body surface area (BSA) (Roman–Table). However, given that BSA takes into consideration patient weight, it can represent a limit for a lower estimation of the real risk index for aortic complications, due to overweight or obesity. We thought to verify whether the aortic risk index and its severity, i.e., low, moderate, high, severe, turns out to be different when compared to patient‘s real BSA at in–hospital admission, or to ideal BSA expected for that specific patient. Methods: Fifty consecutive patients (mean age 67.9±9.1 years, 40 males 10 females) affected by expansive ascending aorta aneurysm (mean diameter 5.2 ±0.6 cm) in the last year and half underwent ascending aorta repair. We considered patient‘s weight, height, real BSA, ideal BSA in relation to the expected weight, and the aortic risk index and its severity calculated for real and ideal BSA. Results: Significant differences were found for BSA (real value 1.92±0.15 m2 vs ideal value 1.78±0.13 m2; P‹0,001), weight (real 79.3±11 kg vs ideal 65.5±7 kg; P‹0,001), and aortic risk index (real value 2.73±0.38 vs ideal value 2.95±0.39; P‹0,01). Differences in the severity degree of the aortic risk index are reported in Table 1. Conclusions: Aortic risk index calculated for BSA at admission may be significantly underestimated, due to excess weight. Estimating the risk with the ideal BSA value, we observe an increase of approximately double of patients at moderate–high risk. This aspect should be carefully evaluated for correct surgical indications