Active Surveillance and Diagnostic Testing

The Elaine & Robert Matranga Aortic Center offers a comprehensive approach to aortic disease, including the use of advanced diagnostic testing and active surveillance. Aortic aneurysms or aortic dissections are often found and diagnosed with an imaging test. Commonly, an aortic aneurysm is discovered during an imaging study which was ordered for a different health care problem.

For some individuals diagnosed with an aortic aneurysm, surgery may not be needed or needed initially. Instead, the Elaine & Robert Matranga Aortic Center will track these patients, using active surveillance, to monitor the size of their aneurysm and watch for signs of growth on a yearly basis. But as the aneurysm grows – the risk for rupture or dissection also increases. Once an aneurysm reaches a certain size in diameter, elective surgery is recommended, since an emergency surgery carries a much greater risk. Some people may live with an aortic aneurysm and never need interventional surgery. If the aneurysm stays small – the chance that a small stable aneurysm will burst is also small.

Diagnostic Testing & Imaging

Hoag utilizes advanced imaging to closely monitor the size and potential growth of the aorta.

3D Imaging Lab

Hoag offers the only onsite state-of-the-art 3D imaging lab in Orange County. Hoag’s aortic radiologists are trained with the latest developments in 3D imaging, and remain up to date as medical imaging constantly evolves. This innovative equipment improves the ability to evaluate small or moving structures such as the coronary arteries, providing better visualization for physicians.

A typical CT scan generates over 3,000 images. This is where 3D post-processing becomes invaluable. By taking the data and manipulating it with sophisticated software, it is possible to create elaborate 3D images of the aorta. Measuring chamber size, cardiac function, vessel diameter, and extent of coronary calcification are just a few of the capabilities afforded by post-processing software available in the 3D lab at Hoag.

In cases of measuring your aortic dimensions, Hoag’s 3D lab precisely measures your aorta at predetermined locations along the length of the aorta. This tracking enables the most accurate aortic measurement to evaluate for any interval growth. Ideally, the preferred imaging technique should be performed using the same technique in the same center for consistency with future comparisons.

Other Diagnostic Imaging

Computed Tomography (CT scan) – Because of its speed and wide availability, CT and computed tomographic angiography is currently the most common diagnostic imaging methods for studying the aorta. CT can provide the excellent resolution necessary to image the aorta accurately with reasonable doses of iodinated contrast medium with a short acquisition time. Limitation on contrast use because of renal insufficiency or a history of iodine allergy usually can be dealt with but should be brought to the attention of your provider.

Magnetic Resonance Imaging and Magnetic Resonance Angiography – MRI and MRA is a premier imaging method for the diagnosis of disease of the thoracic aorta in stable patients. It provides enhanced visualization and eliminates the need for noniodinated contrast and radiation.

Echocardiogram – A transthoracic echocardiogram (TTE) and transesophageal echocardiogram (TEE) play an important role in aortic imaging. Echocardiography is widely available, non-invasive (TTE), or minimally invasive (TEE) can visualize the aortic root and ascending aorta. This ultrasound uses sound waves to evaluate cardiac structure and function. The quantification of cardiac chamber dimensions, area, and volumes are an important aspect of a complete examination. Using a combination of these ultrasound techniques, one can assess the anatomy and function of the cardiac valves, myocardium, and pericardium.

X-Ray – The abnormality of a thoracic aneurysm may be detected on chest radiographs, with the most common finding being widening of the superior mediastinum. However, this picture is not a reliable tool for determining the exact size of your aorta.

Contact Us

The Elaine & Robert Matranga Aortic Center provides every therapeutic advantage, from a highly skilled team to advanced treatment approaches and state-of-the-art facilities. Call us for a consultation or a second opinion at 949-764-5314. For patients who live a long distance from Hoag, we are also available for virtual telehealth visits.