Role of Computed Tomography Angiography in the Short-Term Follow-up of Aortic Coarctation Repair.

Mariana Ribeiro Rodero Cardoso, Ariela Maltarolo Crestani, Antônio Soares Souza, Fernanda Del Campo Braojos Braga, Marília Maroneze Brun, Alexandre Noboru Murakami, Francisco Candido Monteiro Cajueiro, Carlos Henrique De Marchi, Ulisses Alexandre Croti
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Abstract

Introduction: Coarctation of the aorta (CoA) is a narrowing of the thoracic aorta that often manifests as discrete stenosis but may be tortuous or in long segment. The study aimed to evaluate pre and post-surgical aspects of pediatric patients submitted to CoA surgical correction and to identify possible predisposing factors for aortic recoarctation.

Methods: Twenty-five patients were divided into groups according to presence (N=8) or absence (N=17) of recoarctation after surgical correction of CoA and evaluated according to clinical-demographic profile, vascular characteristics via computed angiotomography (CAT), and other pathological conditions.

Results: Majority of males (64%), ≥ 15 days old (76%), ≥ 2.5 kg (80%). There was similarity between groups with and without recoarctation regarding sex (male: 87% vs. 53%; P=0.277), age (≥ 15 days: 62.5 vs. 82%; P=0.505), and weight (≥ 2.5 kg: 87.5 vs. 76.5; P=0,492). Altered values of aortic root/Valsalva diameter, proximal transverse arch, and distal isthmus, and normal values for aorta prevailed in preoperative CAT. Normal values for the aortic root/Valsalva sinus diameter were observed with and without recoarctation, the same for both groups regarding ascending and descending aorta in postoperative CAT. No significant difference for altered values of proximal transverse arch and alteration in distal isthmus was observed.

Conclusion: No predictive risk for recoarctation was observed. CTA proved to be important in CoA diagnosis and management, since CoA is mainly related with altered diameter of aortic root/sinus of Valsalva and proximal and distal aortic arch/isthmus, however, it failed to show predictive risk for recoarctation.

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计算机断层扫描血管造影术在主动脉粥样硬化修复术短期随访中的作用
导言主动脉粥样硬化(CoA)是胸主动脉狭窄的一种,通常表现为不连续的狭窄,但也可能是迂曲的或长段的。该研究旨在评估接受CoA手术矫正的儿科患者的术前和术后情况,并找出主动脉再梗塞的可能诱发因素:根据CoA手术矫治后存在(8例)或不存在(17例)再梗塞的情况将25例患者分为一组,并根据临床-人口学特征、计算机血管造影(CAT)的血管特征以及其他病理情况进行评估:大多数为男性(64%),出生≥15 天(76%),体重≥2.5 千克(80%)。在性别(男性:87% 对 53%;P=0.277)、年龄(≥ 15 天:62.5% 对 82%;P=0.505)和体重(≥ 2.5 千克:87.5 对 76.5;P=0,492)方面,有再梗阻和无再梗阻组之间存在相似性。主动脉根部/Valsalva 直径、近端横弓和远端峡部的数值发生变化,而术前 CAT 中主动脉的数值普遍正常。主动脉根部/Valsalva窦直径的正常值在有和没有再梗塞的情况下均可观察到,在术后CAT中,升主动脉和降主动脉的正常值在两组中均相同。近端横弓的改变值和远端峡部的改变值没有明显差异:结论:未观察到再梗塞的预测风险。CTA 被证明在 CoA 诊断和管理中非常重要,因为 CoA 主要与主动脉根部/瓦尔萨尔瓦窦、主动脉弓近端和远端/峡部直径的改变有关,但它未能显示出再梗死的预测风险。
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