Follow-up aortic dilatation in patients with repaired tetralogy of Fallot using cardiovascular magnetic resonance. (2021)

• Record Type: Journal Article
• Authors: Siripornpitak, Suvipaporn; Sriprachyakul, Apichaya; Wongmetta, Saruntorn; Samankatiwat, Piya; Mokarapong, Pirapat; Wanitkun, Suthep
• Is Part Of: European journal of radiology open. Volume 8(2021)
• Publication Date: 2021
• Subjects: AGR annual growth rate -- Ao-AGR annual growth rate of the aorta -- AoD aortic diameter -- AoR aortic root -- AAo ascending aorta -- CMR cardiac magnetic resonance -- rTOF repaired tetralogy of Fallot -- cine bSSFP cine balanced steady-state free precession -- STJ sinotubular junction -- SoV sinus of Valsalva -- TOF tetralogy of Fallot; Repaired tetralogy of Fallot -- Aortic diameter -- Aortic diameter index -- Annual growth rate -- Annual growth rate index -- Somatic growth; Medical radiology -- Periodicals; 616.075705
• DOI: 10.1016/j.ejro.2021.100354
• Languages: English
• ISSNs: 2352-0477

Abstract

Highlights: Most repaired adolescents with TOF have significant aortic dilatation. Mild increase aortic size with regression of aortic growth index are common. Aortic growth among adolescents is a part of physiologic growth. Aortic growth does not produce adverse effect on aortic regurgitation. Severity of initial aortic size is not a predictor for the rate of aortic growth. Abstract: Purpose: The study sought to determine the rate of aortic expansion and correlation with somatic growth in patients with repaired tetralogy of Fallot (rTOF), and predictors for determining the annual growth rate of the aorta (Ao-AGR). Methods: Ninety-four rTOF patients (mean age 14.5 ± 4.4 years) with two cardiac magnetic resonance tests (CMR) (median duration 52 months, interquartile range, IQR 24–71) were analyzed for aortic diameter (AoD) at the annulus, the sinus of Valsalva (SoV), the sinotubular junction, and the ascending aorta (AAo), and compared with the normal limit AoD (NL-AoD) values. The median age-at-repair was 60 months (IQR 36−84). Ao-AGR and its index (Ao-AGRI) were derived from changes of the AoD and AoD-index, respectively, divided by the duration between the two studies. Three potential predictors (baseline AoD, sex, and age-at-repair) for the progression of Ao-AGR were analyzed. Results: There was a significant larger AoD than NL-AoD ( p < 0.001). Slow aortic growth was encountered in 78–85 % of patients. The Ao-AGR was slow, the median AGR ranged from 0.37 mm (IQR 0.13−0.72) at annulus to 0.56 mm (IQR 0.22−0.91) at AAo. There was a regression in Ao-AGRI, ranged from -1.41 mm (IQR -1.94, -0.87) at annulus to -2.36 mm (IQR -3.09, -1.63) at SoV. The three predictors were not correlated with severity of Ao-AGR. Conclusion: Most adolescents with rTOF show significant aortic dilatation. There is a slow Ao-AGR with regression of Ao-AGRI, which may suggest that the rate of aortic growth is slower than the somatic growth. There are no significant predictors of the progression of Ao-AGR.