Huiyue Xiao, Wei-Hua Lin, Shun-Yong Zheng, Yi-Yong Cai
{"title":"Application of Computed Tomography Angiography in Preoperative Diagnosis of Coarctation of Aorta and Evaluation of Aortic Dilatation in Infants","authors":"Huiyue Xiao, Wei-Hua Lin, Shun-Yong Zheng, Yi-Yong Cai","doi":"10.21470/1678-9741-2023-0160","DOIUrl":null,"url":null,"abstract":"Objective To evaluate the occurrence of aortic dilatation and its associated predictors with coarctation of the aorta (CoA) in infants using multi-slice computed tomography (MSCT). Methods The clinical data of 47 infantile patients with CoA diagnosed by MSCT and 28 infantile patients with simple ventricular septal defect were analyzed retrospectively. Aortic diameters were measured at six different levels, and aortic sizes were compared by z score. The coarctation site-diaphragm ratio was used to describe the degree of narrowing. Relevant clinical data were collated and analyzed. Results The dilation rate and z score of the ascending aorta in the severe CoA group were significantly higher than those in the mild CoA group (11 [52.38%] vs. 21 [80.77%], P=0.038 and 2.00 ± 0.48 vs. 2.36 ± 0.43, P=0.010). Pearson’s correlation analysis found that the z score of the ascending aorta was negatively correlated with the coarctation site-diaphragm ratio value (r=-0.410, P=0.004). A logistic retrospective analysis found that an increased degree of coarctation was an independent predictor of aortic dilatation (adjusted odds ratio 0.002; 95% confidence interval 0.00-0.819; P=0.043). The z score of the ascending aorta in the severe CoA group was significantly higher than that in the ventricular septal defect group (P<0.05). Conclusion Most infants with CoA can also have significant dilatation of the ascending aorta, and the degree of this dilatation is related to the degree of coarctation. Assessment of aortic diameter and related malformations by MSCT can predict the risk of aortic dilatation in infants with CoA.","PeriodicalId":72457,"journal":{"name":"Brazilian journal of cardiovascular surgery","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Brazilian journal of cardiovascular surgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.21470/1678-9741-2023-0160","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Objective To evaluate the occurrence of aortic dilatation and its associated predictors with coarctation of the aorta (CoA) in infants using multi-slice computed tomography (MSCT). Methods The clinical data of 47 infantile patients with CoA diagnosed by MSCT and 28 infantile patients with simple ventricular septal defect were analyzed retrospectively. Aortic diameters were measured at six different levels, and aortic sizes were compared by z score. The coarctation site-diaphragm ratio was used to describe the degree of narrowing. Relevant clinical data were collated and analyzed. Results The dilation rate and z score of the ascending aorta in the severe CoA group were significantly higher than those in the mild CoA group (11 [52.38%] vs. 21 [80.77%], P=0.038 and 2.00 ± 0.48 vs. 2.36 ± 0.43, P=0.010). Pearson’s correlation analysis found that the z score of the ascending aorta was negatively correlated with the coarctation site-diaphragm ratio value (r=-0.410, P=0.004). A logistic retrospective analysis found that an increased degree of coarctation was an independent predictor of aortic dilatation (adjusted odds ratio 0.002; 95% confidence interval 0.00-0.819; P=0.043). The z score of the ascending aorta in the severe CoA group was significantly higher than that in the ventricular septal defect group (P<0.05). Conclusion Most infants with CoA can also have significant dilatation of the ascending aorta, and the degree of this dilatation is related to the degree of coarctation. Assessment of aortic diameter and related malformations by MSCT can predict the risk of aortic dilatation in infants with CoA.
目的 使用多层计算机断层扫描(MSCT)评估婴儿主动脉扩张及其与主动脉共动脉症(CoA)相关的预测因素。方法 回顾性分析了 47 名经 MSCT 诊断为 CoA 的婴儿患者和 28 名单纯室间隔缺损婴儿患者的临床数据。在六个不同层面测量主动脉直径,并通过 z 评分比较主动脉大小。主动脉缩窄部位与膈肌的比例用于描述主动脉缩窄的程度。对相关临床数据进行了整理和分析。结果 重度 CoA 组的升主动脉扩张率和 z 评分明显高于轻度 CoA 组(11 [52.38%] vs. 21 [80.77%],P=0.038;2.00 ± 0.48 vs. 2.36 ± 0.43,P=0.010)。皮尔逊相关分析发现,升主动脉的z评分与共动脉部位-膈肌比值呈负相关(r=-0.410,P=0.004)。一项逻辑回顾性分析发现,共动脉畸形程度的增加是主动脉扩张的独立预测因素(调整后的几率比 0.002;95% 置信区间 0.00-0.819;P=0.043)。严重 CoA 组升主动脉的 z 评分明显高于室间隔缺损组(P<0.05)。结论 大多数 CoA 婴儿的升主动脉也会明显扩张,而扩张的程度与共动脉畸形的程度有关。通过 MSCT 评估主动脉直径和相关畸形可预测 CoA 婴儿主动脉扩张的风险。