Item request has been placed!
×
Item request cannot be made.
×
Processing Request
Pre-operative Imaging of Critical Coarctation of the Aorta: Impact on Surgical Approach and Outcomes.
Item request has been placed!
×
Item request cannot be made.
×
Processing Request
- Additional Information
- Source:
Publisher: Springer Verlag Country of Publication: United States NLM ID: 8003849 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-1971 (Electronic) Linking ISSN: 01720643 NLM ISO Abbreviation: Pediatr Cardiol Subsets: MEDLINE
- Publication Information:
Publication: New York Ny : Springer Verlag
Original Publication: [New York, Springer-Verlag]
- Subject Terms:
- Abstract:
Computed tomographic angiography (CTA) has been increasingly used for the evaluation of infants with aortic arch hypoplasia and coarctation of the aorta. The goals of this study were to compare echocardiographic and CTA findings in critical coarctation of the aorta, to evaluate each modality's influence on surgical approach for repair and determine if pre-operative measurements or surgical approach are associated with residual lesions/re-interventions. This was a single-center retrospective cohort study that included 85 neonates and infants who underwent repair of coarctation/arch hypoplasia by three months of age. Two groups were compared: patients with pre-operative echocardiograms only and patients with both echocardiogram and CTA evaluations. 44 (52%) patients received an echocardiogram and CTA, and 41 (48%) patients received an echocardiogram only. Patients in the CTA + echo group had smaller mitral valve and ascending aorta measurements (p = 0.01). When comparing CTA to echocardiogram measurements, the aortic valve annulus, ascending aorta, proximal and distal transverse arch, and isthmus were smaller on echo (p < 0.01). A smaller aortic valve annulus and aortic root as well as thoracotomy approach were associated with residual gradients/re-intervention (p < 0.01). Our study found that patients who underwent CTA preoperatively had smaller left-sided structures. Aortic measurements were smaller on echocardiogram when compared to CTA. Smaller left-sided structures proximal to the aortic arch and thoracotomy predicted the development of residual lesions/re-intervention. CTA is useful in the surgical planning for neonates with arch hypoplasia/coarctation and may help risk stratify for residual lesions/re-intervention.
(© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
- References:
J Thorac Imaging. 2020 Nov 1;35(6):399-406. (PMID: 32251236)
J Thorac Cardiovasc Surg. 2001 Nov;122(5):883-90. (PMID: 11689792)
Ann Thorac Surg. 2009 Dec;88(6):1932-8. (PMID: 19932265)
Pediatr Cardiol. 2021 Oct;42(7):1567-1574. (PMID: 34052859)
Ann Thorac Surg. 2019 Jan;107(1):157-164. (PMID: 30205114)
Pediatr Cardiol. 2013 Mar;34(3):518-24. (PMID: 22956060)
Cardiol Young. 2019 Jul;29(7):885-887. (PMID: 31296278)
Pediatr Radiol. 2010 Apr;40(4):518-27. (PMID: 20225116)
J Thorac Cardiovasc Surg. 2013 Jul;146(1):229-32. (PMID: 23395099)
World J Pediatr Congenit Heart Surg. 2017 Mar;8(2):196-202. (PMID: 28329462)
Int J Cardiovasc Imaging. 2021 Apr;37(4):1455-1460. (PMID: 33392877)
Cardiol Young. 2016 Dec;26(8):1553-1562. (PMID: 28148317)
J Thorac Imaging. 2009 Aug;24(3):223-6. (PMID: 19704327)
Radiographics. 2002 Mar-Apr;22(2):337-47; discussion 348-9. (PMID: 11896223)
J Comput Assist Tomogr. 2013 Jan-Feb;37(1):75-8. (PMID: 23321836)
Interact Cardiovasc Thorac Surg. 2012 Nov;15(5):865-70. (PMID: 22833510)
- Grant Information:
K23 HL133447 United States HL NHLBI NIH HHS
- Contributed Indexing:
Keywords: Coarctation; Computed tomographic angiography; Echocardiography
- Publication Date:
Date Created: 20231023 Date Completed: 20240110 Latest Revision: 20240916
- Publication Date:
20240916
- Accession Number:
PMC11402457
- Accession Number:
10.1007/s00246-023-03316-5
- Accession Number:
37872348
No Comments.