- Poster presentation
- Open Access
Mechanical and morphological properties of the aortic root and arch late after arterial switch operation for transposition of the great arteries
© Ntsinjana et al; licensee BioMed Central Ltd. 2012
- Published: 1 February 2012
- Cardiovascular Magnetic Resonance
- Aortic Root
- Aortic Flow
- Arterial Switch Operation
- Brachial Blood Pressure
The arterial Switch operation (ASO) is now performed routinely for the repair of transposition of the great arteries (TGA). Neo-aortic root dilatation and reduced elasticity of the ascending aorta have been shown to impact the long-term outcomes of these patients.
The aim of this study was to assess the effect of the ASO with the Lecompte maneuver on the dynamic behavior and dimensions of the aortic root, and the shape and curvature of the ascending aorta and aortic arch.
Data was reviewed from nineteen TGA subjects (14.3±2.6 years, 1.6±0.3 m2 BSA) and twenty matched control subjects (15.0±2.4 years, 1.7±0.2 m2 BSA), who had undergone cardiovascular magnetic resonance (CMR) imaging for clinical indications at our Institution. Aortic flows at the root level and 3D Whole-Heart bSSFP were obtained using standard CMR sequences. Both groups had non-invasive brachial blood pressure cuff measurements. 3D Whole-Heart bSSFP images were used to create 3D models for each patient using commercial software (Mimics, Materialise, Belgium) and the volume 3D centerline from ventricular apex to the descending aorta was calculated in order to better describe aortic geometry. Aortic flows and area changes were then analyzed from magnitude and phase-contrast images with an in-house written plugin (Osirix, Pigmeo, Switzerland) using an automatic propagation algorithm based on non-rigid registration.
Changes in morphology, dimensions and dynamics observed in the ASO group suggest overall increased impedance, which is likely to be the mechanistic explanation for the long-term outcomes of this procedure.
Carnegie Foundation, Fondation Leducq, UK National Institute of Health Research (NIHR), Royal Academy of Engineering and EPSRC.
This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.