title: The apex of the aortic arch backshifts with aging.
abstract: BACKGROUND
  Only a few studies, involving small numbers of patients, have globally assessed the curvature of the thoracic aorta but without any details concerning the location of the supra-aortic trunks.
  
  
  OBJECTIVE
  Using CT to describe normal aortic-arch morphology and its changes with age and sex.
  
  
  METHODS
  344 CT scans were studied. We measured the distances from the apex to the ascending and descending aorta, the curvilinear length of the entire arch, that of the segment, including bifurcations of supra-aortic vessels, and the angle, height, and shift of the arch.
  
  
  RESULTS
  In men, the arch was significantly longer (146.2 vs 122.8 mm; p < 0.001), higher (49.3 vs 40.1 mm, p < 0.001), and wider transversely (83.6 vs 73.3 mm; p < 0.001) than in women. The average men's arch also had a more acute angle at the apex (79.7° vs 83.7° p < 0.001). Neither morphology nor age influenced the winding angle around the mediastinum. Aging was accompanied by deflection and extension of the aortic arch, which grew more anteroposteriorly (6.1 mm/10 years in men) than vertically (2.5 mm/10 years in men), while the apex moved towards the rear of the arch. The ascending aorta was the only curvilinear length unaffected by age, whereas the supra-aortic trunks parted from each other.
  
  
  CONCLUSIONS
  We believe that all these original observations could lead to a better assessment of normal aging of the aorta and guide technical choices during surgical or hybrid procedures.
authors.affiliation: Heart Surgery Department, Clermont-Ferrand University Hospital, Place H. Dunant, 63000, Clermont-Ferrand, France. ndostrevy@chu-clermontferrand.fr.|ISIT-UMR 6284 UdA-CNRS, Institut des Sciences de l'Image pour les Techniques interventionnelles, Clermont Université, Université d'Auvergne, BP 10448, 63000, Clermont-Ferrand, France. ndostrevy@chu-clermontferrand.fr.
authors.forename: N
authors.initials: N
authors.lastname: d'ostrevy
authors.affiliation: Radiology Department, Clermont-Ferrand University Hospital, 63000, Clermont-Ferrand, France.
authors.forename: F D
authors.initials: FD
authors.lastname: Ardellier
authors.affiliation: Radiology Department, Clermont-Ferrand University Hospital, 63000, Clermont-Ferrand, France.|ISIT-UMR 6284 UdA-CNRS, Institut des Sciences de l'Image pour les Techniques interventionnelles, Clermont Université, Université d'Auvergne, BP 10448, 63000, Clermont-Ferrand, France.
authors.forename: L
authors.initials: L
authors.lastname: Cassagnes
authors.affiliation: ISIT-UMR 6284 UdA-CNRS, Institut des Sciences de l'Image pour les Techniques interventionnelles, Clermont Université, Université d'Auvergne, BP 10448, 63000, Clermont-Ferrand, France.|Laboratoire de Biostatistique Informatique Médicale et Technologies de Communication, University Clermont1, 63000, Clermont-Ferrand, France.
authors.forename: L
authors.initials: L
authors.lastname: Ouchchane
authors.affiliation: Heart Surgery Department, Clermont-Ferrand University Hospital, Place H. Dunant, 63000, Clermont-Ferrand, France.|INRA, UMR 1019 Nutrition Humaine, 63122, Saint Genès Champanelle, France.
authors.forename: K
authors.initials: K
authors.lastname: Azarnoush
authors.affiliation: Heart Surgery Department, Clermont-Ferrand University Hospital, Place H. Dunant, 63000, Clermont-Ferrand, France.|ISIT-UMR 6284 UdA-CNRS, Institut des Sciences de l'Image pour les Techniques interventionnelles, Clermont Université, Université d'Auvergne, BP 10448, 63000, Clermont-Ferrand, France.
authors.forename: L
authors.initials: L
authors.lastname: Camilleri
authors.affiliation: Laboratoire d'anatomie, University Clermont1, 63000, Clermont-Ferrand, France.
authors.forename: L
authors.initials: L
authors.lastname: Sakka
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000473:pathology*; D001013:Aorta, Thoracic / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: Anatomy; Aorta; Curvature; Supra-aortic trunks; Thoracic; Tomodensitometry