title: 'Bovine' aortic arch - a marker for thoracic aortic disease.
abstract: OBJECTIVE
  Very few studies have addressed the clinical significance of 'bovine' aortic arch (BA). We sought to determine whether BA is associated with thoracic aortic disease, including thoracic aortic aneurysm, aortic dissection, aortic rupture, and accelerated aortic growth rate.
  
  
  METHODS
  We retrospectively reviewed CT and/or MRI scans of 612 patients with thoracic aortic disease and 844 patients without thoracic aortic disease to determine BA prevalence. In patients with thoracic aortic disease, we reviewed hospital records to determine growth rate, prevalence of dissection and rupture, and accuracy of radiology reports in citing BA.
  
  
  RESULTS
  26.3% of the patients with thoracic aortic disease had concomitant BA, compared to 16.4% of the patients without thoracic aortic disease (p < 0.001). There was no association between BA and prevalence of dissection or rupture (p = 0.38 and p = 0.56, respectively). The aortic expansion rate was 0.29 cm/year in the BA group and 0.09 cm/year in the non-BA group (p = 0.004). Radiology reports cited BA in only 16.1% of the affected patients.
  
  
  CONCLUSIONS
  (1) BA is significantly more common in patients with thoracic aortic disease than in the general population. (2) Aortas expand more rapidly in the setting of BA. (3) Radiology reports often overlook BA. (4) BA should not be considered a 'normal' anatomic variant.
authors.affiliation: Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Hornick
authors.forename: Remo
authors.initials: R
authors.lastname: Moomiaie
authors.forename: Hamid
authors.initials: H
authors.lastname: Mojibian
authors.forename: Bulat
authors.initials: B
authors.lastname: Ziganshin
authors.forename: Zakaria
authors.initials: Z
authors.lastname: Almuwaqqat
authors.forename: Esther S
authors.initials: ES
authors.lastname: Lee
authors.forename: John A
authors.initials: JA
authors.lastname: Rizzo
authors.forename: Maryann
authors.initials: M
authors.lastname: Tranquilli
authors.forename: John A
authors.initials: JA
authors.lastname: Elefteriades
mesh_terms: D000784:Aortic Dissection / Q000209:etiology* / Q000473:pathology; D001013:Aorta, Thoracic / Q000002:abnormalities*; D017545:Aortic Aneurysm, Thoracic / Q000209:etiology* / Q000473:pathology; D001019:Aortic Rupture / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed