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Magnetic resonance imaging assessment of aortic dilatation and distensibility in 269 patients with repaired tetralogy of Fallot

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Abstract

Purpose

To determine the prevalence and degree of aortic dilatation (Adilatation), severity of aortic stiffness (Astiff), factors for Adilatation, and level of aortic root most sensitive to Astiff in patients with repaired tetralogy of Fallot (rTOF).

Materials and methods

269 patients with rTOF (mean age 14.9 ± standard deviation 5.0 years) were analyzed for Adilatation at annulus, sinus, sinotubular junction, and ascending aorta (aAo). Aortic size index was graded as Z score < 2, 2–2.99, 3–4.99 and ≥ 5. Aortic distensibility (aAdis) was categorized according to 4 aortic levels and dilatation severity. Factors for Adilatation and level of aortic root most sensitive to Astiff were analyzed.

Results

Sinus and aAo were the two most common sites of Adilatation, with a prevalence of 84% and 76%, respectively. A decreased aAdis was found (mean 5.38 ± 1.79 10−3 mmHg−1). aAdis only declined significantly at the sinus level (p = 0.009). Male sex, age-at-repair and aortic regurgitation were significant factors for Adilatation, with male sex as the strongest factor (odds ratio 2.94). There was a significant decline in aAdis at sinus level (p = 0.002) as Adilatation progressed.

Conclusions

We observed a high prevalence of Adilatation and Astiff in patients with rTOF. Male sex is the strongest factor for Adilatation. The sinus is the most sensitive area for determining a negative aAdis effect.

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Abbreviations

aAo:

Ascending aorta

aA dis :

Aortic distensibility

A stiff :

Aortic stiffness

aAomax-area :

Maximal ascending aortic luminal areas

aAomin-area :

Minimal ascending aortic luminal areas

A dilatation :

Aortic dilatation

bSSFP:

Balanced steady-state free precession

LVEF:

Left ventricular ejection fraction

LVOT:

Left ventricular outflow tract

MRI:

Magnetic resonance imaging

PC-VENC:

Phase contrast velocity encoded

RF:

Regurgitation fraction

rTOF:

Repaired tetralogy of Fallot

STJ:

Sinotubular junction

TOF:

Tetralogy of Fallot

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Authors and Affiliations

  1. Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama 6 Road, Phayatai, Ratchathewi, Bangkok, 10400, Thailand

    Suvipaporn Siripornpitak, Apichaya Sriprachyakul & Saruntorn Wongmetta

  2. Division of Thoracic Surgery, Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama 6 Road, Phayatai, Ratchathewi, Bangkok, 10400, Thailand

    Piya Samankatiwat

  3. Department of Surgery, Cardiovascular and Thoracic Surgery Unit, Institute of Cardiovascular Diseases, Rajvithi Hospital, 2 Phayatai Road, Ratchathewi, Bangkok, 10400, Thailand

    Pirapat Mokarapong

  4. Division of Cardiology, Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama 6 Road, Phayatai, Ratchathewi, Bangkok, 10400, Thailand

    Suthep Wanitkun

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  1. Suvipaporn Siripornpitak
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  2. Apichaya Sriprachyakul
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Correspondence to Suvipaporn Siripornpitak.

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All procedures performed in these studies were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the institutional Human Research Ethics Committee, Faculty of Medicine, Ramathibodi Hospital, Mahidol University.

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Siripornpitak, S., Sriprachyakul, A., Wongmetta, S. et al. Magnetic resonance imaging assessment of aortic dilatation and distensibility in 269 patients with repaired tetralogy of Fallot. Jpn J Radiol 39, 774–782 (2021). https://doi.org/10.1007/s11604-021-01119-3

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  • DOI: https://doi.org/10.1007/s11604-021-01119-3

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