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Dimensions of the Ascending Aorta in Conotruncal Heart Defects

Trippel, Amedeo ; Pallivathukal, Sabine ; Pfammatter, Jean-Pierre ; Hutter, Damian ; Kadner, Alexander ; Pavlovic, Mladen

In: Pediatric Cardiology, 2014, vol. 35, no. 5, p. 831-837

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    Title
    • Dimensions of the Ascending Aorta in Conotruncal Heart Defects
    Author
    • Trippel, Amedeo. Department of Cardiology, University Hospital, 3010, Berne, Switzerland
    • Pallivathukal, Sabine. Department of Cardiology, University Hospital, 3010, Berne, Switzerland
    • Pfammatter, Jean-Pierre. Department of Cardiology, University Hospital, 3010, Berne, Switzerland
    • Hutter, Damian. Department of Cardiology, University Hospital, 3010, Berne, Switzerland
    • Kadner, Alexander. University Children's Hospital, 3010, Berne, Switzerland
    • Pavlovic, Mladen. Department of Cardiology, University Hospital, 3010, Berne, Switzerland
    Document Type
    • Postprint
    Language
    • English
    Published in
    • Pediatric Cardiology, 2014, vol. 35, no. 5, p. 831-837. Springer US; http://www.springer-ny.com
    Other Version
    OAI-PMH Identifier
    • oai:doc.rero.ch:324998
    Summary
    Dilatation of the ascending aorta is an important sequel in conotruncal anomalies, such as tetralogy of Fallot (TOF) or d-transposition of the great arteries (TGA). We measured dimensions and their progression at different levels of the ascending aorta in 80 patients. In TOF patients, mean z-score for aortic annulus was 1.65 (range −3.16-6.47), for sinus 1.93 (range −2.28-5.39), for st-junction 4.15 (range 0.0-8.18), and for ascending aorta 3.51 (range −1.23-6.36). Over time, annulus z-scores increased in the univariate analysis [0.07/year, 95% confidence interval (CI) 0.01-0.14; p=0.02], and this was unique to male patients (0.08/year, 95% CI 0.00-0.15; p=0.05). z-scores of the ascending aorta decreased (−0.1/year, 95% CI −0.18 to −0.02; p=0.02), and this was confined to patients without aortic regurgitation (AR; −0.09/year, 95% CI −0.18 to −0.01; p=0.04). In TGA, mean z-score for the aortic annulus was 2.13 (range −3.71-8.39), for sinus 1.77 (range −3.04-6.69), for st-junction 1.01 (range −5.44-6.71), and for ascending aorta 0.82 (range −4.91-6.46). In bivariate analysis, annulus z-scores decreased in females (−0.14/year, 95% CI −0.25 to −0.03; p=0.01) and in patients without AR (−0.07/year, 95% CI −0.14-0.0; p=0.03). z-scores of the ascending aorta increased significantly in males (0.08/year, 95% CI 0.0 to 0.16; p=0.05) and in patients with AR (0.12/year, 95% CI 0.03-0.21; p=0.01). In conclusion, TOF and TGA z-scores of the ascending aorta differ significantly from those of the normal population. Progression of z-scores over time is influenced by diagnosis, sex, and presence of AR.