- Poster presentation
- Open Access
Complications of aortic coarctation repair assessed using cardiac magnetic resonance imaging
© Chen and Mohiaddin; licensee BioMed Central Ltd. 2009
- Published: 28 January 2009
- Cardiac Magnetic Resonance
- Balloon Dilatation
- Cardiac Magnetic Resonance Imaging
- Aortic Coarctation
- Residual Stenosis
Coarctation of the aorta (CoA) accounts for up to 10% of all congenital heart defects. Open repair with surgical reconstruction has been the main form of treatment and more recently, aortic stenting has been used as a less invasive technique without the need for cardiac bypass. The long term success and impact of repair on the structure of the aorta is important with regard to morbidity and management of these patients.
We used cardiac magnetic resonance imaging (CMR) to assess the long term success of repair of CoA with respect to structural complications and residual stenosis.
CMR studies performed in patients with repaired CoA from January 2005 to September 2008 were reviewed. Details of age at, date and type of repair were obtained from patient medical notes. Multi-slice HASTE, cine and turbo-spine echo T2 images, and aortic in-plane and through-plane flow studies were analysed for complications of repair (aneurysmal dilatation, false aneurysm, dissection) and residual stenosis. Aneurysmal dilatation was defined as localised widening at the repair site in comparison to the diameter of the pre- and post-aortic segments. Residual stenosis was defined as constriction at the repair site with flow acceleration on in-plane flow analysis, ± peak recorded velocity on through-plane measurement of >1.5 m/s.
Types of aortic coarctation repair and the main complications
Aneurysmal dilatation (%within the type of repair)
Suture line false aneurysm (%within type of repair)
Residual stenosis (%within type of repair)
Resection and end-to-end anastomosis
Patch and flap aneurysms are frequent complications of patch and subclavian flap repair of aortic coarctation, and the rate of residual stenosis with resection and end-to-end anastomosis was high. Balloon dilatation had minimal complications, but frequent residual stenosis. Graft and bypass graft repair are the most favourable surgical repairs with limited complications and residual stenosis. Aortic stenting also appears quite successful with few complications and residual stenosis but long term follow-up is not yet available.
This article is published under license to BioMed Central Ltd.