Is it important to assess the ascending aorta after tetralogy of Fallot repair?

Rev Port Cardiol (Engl Ed)

Centro Hospitalar São João, Department of Cardiology, Porto, Portugal; University of Porto, Faculty of Medicine, Porto, Portugal.

Published: September 2018

AI Article Synopsis

  • After fixing a heart problem called tetralogy of Fallot, some adults may develop a widening of a part of the aorta (the main blood vessel) years later.
  • A study looked at 78 adults, finding that 11.5% had this widening, and it was more common in older males and those with bigger heart sizes.
  • The researchers suggest that checking the aorta should be a regular part of heart scans for these patients to catch any problems early, especially for those with specific risk factors.

Article Abstract

Introduction And Objectives: Aortic dilatation can develop late after tetralogy of Fallot repair. Its extension beyond the aortic root is not clearly understood. We aimed to assess the prevalence and predictors of ascending aorta dilatation to set up an imaging protocol.

Methods: In this prospective study including adult patients after tetralogy of Fallot repair followed at a referral center, we assessed the aorta by cardiovascular magnetic resonance and defined ascending aorta dilatation as an observed-to-expected ratio >1.5.

Results: We included 78 adults (mean age 31±10 years; 56% female), with a mean follow-up of 23±7 years since tetralogy of Fallot repair. The prevalence of ascending aorta dilatation was 11.5%. The ascending aorta was larger than the sinuses of Valsalva in 12.8% of cases. Patients with ascending aorta dilatation were older, predominantly male, with later repair and larger left ventricular mass and volumes. By multivariate analysis left ventricular mass index (LVMI) was the only factor independently associated with ascending aorta dilatation (odds ratio 1.10, 95% confidence interval 1.01-1.20, p=0.03). A cut-off value of ≥57.9 g/m for LVMI had 89% sensitivity and 71% specificity for ascending aorta dilatation.

Conclusions: Ascending aorta assessment as part of a routine cardiovascular magnetic resonance study after tetralogy of Fallot repair is recommended to screen for future aortic complications, particularly in males and older patients, and those with later repair and larger left ventricles. LVMI assessment has potential as a screening tool for ascending aorta dilatation with future clinical implications.

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.repc.2017.11.014DOI Listing

Publication Analysis

Top Keywords

ascending aorta
40
aorta dilatation
24
tetralogy fallot
20
fallot repair
16
aorta
11
ascending
9
cardiovascular magnetic
8
magnetic resonance
8
repair larger
8
larger left
8

Similar Publications

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!