Aortic Root Dilatation Measured by Cardiac Magnetic Resonance in Patients with Repaired Tetralogy of Fallot.

IF 0.7 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Heart Surgery Forum Pub Date : 2023-06-25 DOI:10.1532/hsf.5547
Paweena Chungsomprasong, Chutima Kraikriangsri, Chodchanok Vijarnsorn, Prakul Chanthong, Kritvikrom Durongpisitkul, Thita Pacharapakornpong, Supaluck Kanjanauthai, Supaporn Nakyen, Jarupim Soongswang
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Abstract

Background: Aortic root dilatation (AoD) frequently occurs following repaired tetralogy of Fallot (rTOF). The objective of this study was to assess aortic dimensions, investigate the prevalence of AoD, and identify predictors of AoD in rTOF patients.

Methods: A cross-sectional retrospective study was conducted in repaired TOF patients from 2009 to 2020. Aortic root diameters were measured by cardiac magnetic resonance (CMR). Severe AoD of the aortic sinus (AoS) was defined as a Z-score (z) of >4, reflecting a mean percentile ≥99.99%.

Results: Two hundred forty-eight patients, with a median age of 28.2 years (10.2-65.3 years), were included in the study. The median age at the time of repair was 6.6 years (0.8-40.5 years) and the median interval between the repair and CMR study was 18.9 years (2.0-54.8 years). The prevalence of severe AoD was found to be 35.2% when defined by an AoS z greater than 4 and 27.6% when defined by a AoS diameter ≥40 mm, respectively. A total of 101 patients (40.7%) had aortic regurgitation (AR), with 7 patients (2.8%) having moderate AR. Multivariate analysis revealed that severe AoD was only associated with the left ventricular end diastolic volume index (LVEDVi) and a longer duration after repair. The age at the time of repair for TOF was found not to be correlated with the development of AoD.

Conclusions: After repair of TOF, severe AoD was found to be prevalent, but no fatal complications were observed in our study. Mild AR was also commonly observed. Larger LVEDVi and a longer duration after repair were identified as factors associated with the development of severe AoD. Therefore, routine monitoring of AoD is recommended.

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修复法洛四联症患者主动脉根部扩张的心脏磁共振测量。
背景:主动脉根部扩张(AoD)经常发生在修复法洛四联症(rTOF)后。本研究的目的是评估主动脉尺寸,调查AoD的患病率,并确定rTOF患者AoD的预测因素。方法:对2009 ~ 2020年修复性TOF患者进行横断面回顾性研究。采用心脏磁共振(CMR)测量主动脉根部直径。主动脉窦严重AoD (AoS)定义为z -score (z) >4,反映平均百分位数≥99.99%。结果:248例患者纳入研究,中位年龄28.2岁(10.2-65.3岁)。修复时的中位年龄为6.6岁(0.8-40.5岁),修复和CMR研究之间的中位间隔为18.9岁(2.0-54.8岁)。重度AoD的发生率以AoS直径大于4定义为35.2%,以AoS直径≥40 mm定义为27.6%。共有101例(40.7%)患者存在主动脉瓣反流(AR), 7例(2.8%)患者存在中度AR。多因素分析显示,重度AoD仅与左室舒张末期容积指数(LVEDVi)和修复后持续时间较长有关。发现TOF修复时的年龄与AoD的发展无关。结论:TOF修复后,严重的AoD普遍存在,但本研究未见致命并发症。轻度AR也很常见。较大的LVEDVi和较长的修复时间被认为是与严重AoD发展相关的因素。因此,建议对AoD进行常规监测。
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来源期刊
Heart Surgery Forum
Heart Surgery Forum 医学-外科
CiteScore
1.20
自引率
16.70%
发文量
130
审稿时长
6-12 weeks
期刊介绍: The Heart Surgery Forum® is an international peer-reviewed, open access journal seeking original investigative and clinical work on any subject germane to the science or practice of modern cardiac care. The HSF publishes original scientific reports, collective reviews, case reports, editorials, and letters to the editor. New manuscripts are reviewed by reviewers for originality, content, relevancy and adherence to scientific principles in a double-blind process. The HSF features a streamlined submission and peer review process with an anticipated completion time of 30 to 60 days from the date of receipt of the original manuscript. Authors are encouraged to submit full color images and video that will be included in the web version of the journal at no charge.
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