title: Moderate aortic enlargement and bicuspid aortic valve are associated with aortic dissection in Turner syndrome: report of the international turner syndrome aortic dissection registry.
abstract: BACKGROUND
  Girls and women with Turner syndrome are at risk for aortic dissection and rupture. However, the size of the aorta and the clinical characteristics among those with Turner syndrome and dissection have received little attention.
  
  
  RESULTS
  We obtained medical records from 20 individuals who voluntarily participated in the International Turner Syndrome Aortic Dissection Registry. Type A dissections occurred in 17 of 20 (85%) cases, and type B occurred in 3 cases of which 1 occurred after coarctation stent placement. Of those with spontaneous aortic dissections, 18 of 19 (95%) had an associated cardiac malformation that included a bicuspid aortic valve. In 1 individual there was no predisposing finding other than the presence of Turner syndrome. Associated pregnancy was documented in 1 of 19 (5%). More than half (13/19, 68%) came to medical attention >24 hours after the onset of symptoms. For those with type A dissections, the mean ascending aortic size index was 2.7±0.6 cm/m(2) (n=9).
  
  
  CONCLUSIONS
  Aortic dissection in Turner syndrome occurs in young individuals at smaller aortic diameters than in the general population or other forms of genetically triggered aortopathy. The absence of aortic valve or other cardiac malformations appears to markedly reduce the risk of aortic dissection However, aortic dissection can occur in Turner syndrome without cardiac malformations or hypertension. Individuals with Turner syndrome who are >18 years of age with an ascending aortic size index >2.5 cm/m(2) should be considered for an aortic operation to prevent aortic dissection.
authors.affiliation: Oregon Health and Science University, Portland, OR 97239, USA.
authors.forename: Misty
authors.initials: M
authors.lastname: Carlson
authors.forename: Nathan
authors.initials: N
authors.lastname: Airhart
authors.forename: Leo
authors.initials: L
authors.lastname: Lopez
authors.forename: Michael
authors.initials: M
authors.lastname: Silberbach
mesh_terms: D000015:Abnormalities, Multiple / Q000453:epidemiology / Q000235:genetics; D000293:Adolescent; D000328:Adult; D000784:Aortic Dissection / Q000145:classification / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology / Q000517:prevention & control; D000886:Anthropometry; D001011:Aorta / Q000000981:diagnostic imaging / Q000473:pathology; D001014:Aortic Aneurysm / Q000145:classification / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology / Q000517:prevention & control; D001017:Aortic Coarctation / Q000453:epidemiology / Q000235:genetics / Q000601:surgery; D001021:Aortic Valve / Q000002:abnormalities* / Q000000981:diagnostic imaging; D006348:Cardiac Surgical Procedures / Q000706:statistics & numerical data; D005260:Female; D006330:Heart Defects, Congenital / Q000453:epidemiology / Q000235:genetics; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000235:genetics; D011247:Pregnancy; D011248:Pregnancy Complications / Q000235:genetics; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014424:Turner Syndrome / Q000150:complications / Q000473:pathology*; D014463:Ultrasonography; D055815:Young Adult