Aortic root and ascending aortic dilatation in patients with repaired tetralogy of Fallot. Determinants, rates of progression, impacts on outcomes and relations to branch pulmonary artery stenosis
© Bonello et al; licensee BioMed Central Ltd. 2013
Published: 30 January 2013
We examined features, progression and relations to outcomes of aortic dilatation (AD) in adults with repaired tetralogy of fallot (rtoF).
Materials and methods
Retrospective study of 110 rtoF adults with native aorta, median age 30.9 (22.9-39.4) years were studied by cardiovascular magnetic resonance (CMR) at baseline, and at follow-up (median 6.3 [IQR:5.1-7.6] years). Aortic measurements were performed at sinus, sino-tubular junction (STJ), and mid-ascending aorta level. AD was defined as diameter > 2 standard deviations larger than published normal Z-Scores, according to the age and body surface area.
Aortic dilatation is common in patients with rtoF but rates of diameter increase in mid-term follow-up are low when assessed by serial CMR. However, when observed, the diameter progression is superior to the one expected with the age. Ascending aorta dilatation is likely when aortic sinus diameter is greater than 39mm. Our data provides guidance on the need of aortic intervention in contemporary adult cohort with rtoF.
British Heart Foundation Fellowship (SVB-N).
French Federation of Cardiology (BB).
Unrestricted Actelion educational grant (GD).
The study was supported by the NIHR Cardiovascular Biomedical Research Unit of Royal Brompton and Harefield NHS Foundation Trust and Imperial College London.
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