Porcelain aorta
A porcelain aorta refers to circumferential calcification of the ascending aorta. This finding is important to recognize in the preoperative evaluation of cardiac surgery as it complicates cardiac surgeries that require cross-clamping or accessing the aorta (such as open aortic valve replacement or coronary artery bypass grafting). Modification of surgical technique or changing to a minimally invasive approach (such as transcatheter aortic valve implantation) may be required.
Epidemiology
The incidence varies depending on the definition of circumferential involvement, ranging from 0.6% to 19% .
Pathology
Ascending aorta calcification is usually due to atherosclerosis, which affects the innermost layer of the aortic wall, the tunica intima. Non-atheromatous causes affect the tunica media .
Radiographic features
Heavy calcification of the aorta may be detected by fluoroscopy, radiograph, ultrasound or CT, with the latter providing the most detailed anatomic information for surgical planning.