Histopathologic changes in ascending aorta and risk factors related to histopathologic conditions and aortic dilatation in patients with tetralogy of Fallot

Chowdhury, Ujjwal K.; Mishra, Anand Kumar; Ray, Ruma; Kalaivani, Mani; Reddy, Srinivas Gosla; Venugopal, Panangipalli

doi:10.1016/j.jtcvs.2007.06.011

Cited by 64 publications

(45 citation statements)

References 23 publications

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“…Chowdhury et al, reported aortic diameter measured by echocardiography showed significant dilatation in 66.3% of unrepaired patients with TOF in one publication and 68.9% in another publication [38]. In our study, aortic root diameter measured by MDCT showed significant dilation in 70% of unrepaired TOF patients.…”

Section: Aortic Root Dilatation In Unrepaired Tetralogy Of Fallotsupporting

confidence: 60%

“…Chowdhury et al, demonstrated the presence of MAPCAs in (52.9%) of 51 patients with aortic root dilatation. Medionecrosis, one of the histological abnormalities of the aortic media in dilated aorta was more prevalent in patients with presence of MAPCAs [38]. In our study 54.29% of 35 patients with aortic root dilatation had MAPCs and or PDA.…”

Section: Aortic Root Dilatation In Unrepaired Tetralogy Of Fallotsupporting

confidence: 50%

“…Secondly, histological changes of the aortic media resembling those observed in patients with Marfan syndrome and bicuspid aortic valve So-called "cystic medial necrosis" is a misnomer because necrosis is seldom encountered and there are no true cysts; nonetheless, there is a non-inflammatory loss of smooth muscle cells, mucoid degeneration, and fragmentation of the elastic fibers within the media [34]. Incidence of male sex was 86.2% among TOF patients with dilated aorta [38]. In our study, we reported 85.71% incidence of male sex among TOF patients with dilated aorta which was statistically significant.…”

Section: Aortic Root Dilatation In Unrepaired Tetralogy Of Fallotmentioning

confidence: 99%

“…Therefore, aortic dilatation and increased aortic stiffness due to aortic wall pathology in TOF patients may have a contributive effect on the development of AR and LV dysfunction, in addition to adverse right-to-left ventricular interaction [50]. Chowdhury et al reported (60.7%) incidence of aortic dilatation in patients with double outlet right ventricle (DORV) or TOF with pulmonary atresia; he demonstrated a relationship between aortic root dilatation and the presence of DORV [38]. In our study (62.16%) of unrepaired dilator TOF patients had double outlet right ventricle (DORV) or TOF with pulmonary atresia, also we demonstrated a significant correlation between aortic root dilatation and the presence of DORV.…”

Section: Aortic Root Dilatation In Unrepaired Tetralogy Of Fallotmentioning

confidence: 99%

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Predictors for Dilated Aorta in Repaired and Unrepaired Tetralogy of Fallot

Meguid¹,

Mahmoud²,

Mohammad³

2015

WJCD

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Aortic root pathology has been described in patients with Tetralogy of Fallot, although the most common reason for repeat surgery in the adult after TOF repair relates to problems in the right ventricular outflow tract, the aortic root is often forgotten. Objective: We sought to determine those patients with known Fallot tetrallogy at risk for progressive dilatation of the thoracic aorta and explore the common predictors present in this patient group. Methods and Results: A multicenter observational study which enrolled 100 patients (50 surgically repaired and 50 before surgical repair of TOF) with standardized reassessment of echocardiographic parameters and multislice CT angiography of the heart and great vessels data. The data were reviewed and analyzed according to the demographic, morphological, surgical and clinical details. We used standard nomograms and Z score for aortic root dimensions at the level of aortic annulus, sino- 23422% of patients after intra-cardiac repair of TOF. Older age at repair, long shunt to repair interval and residual ventricular septal defect are the most common variables associated with aortopathy and aortic regurgitation in such group of patients. The second important finding is the occurrence of aortic root dilatation in 70% of patients before surgical repair of TOF; whereas male sex and TOF with pulmonary atresia appeared to be the most common variables associated with aortopathy and aortic regurgitation in this group of patients.

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Section: Aortic Root Dilatation In Unrepaired Tetralogy Of Fallotsupporting

confidence: 60%

Section: Aortic Root Dilatation In Unrepaired Tetralogy Of Fallotsupporting

confidence: 50%

Section: Aortic Root Dilatation In Unrepaired Tetralogy Of Fallotmentioning

confidence: 99%

Section: Aortic Root Dilatation In Unrepaired Tetralogy Of Fallotmentioning

confidence: 99%

See 2 more Smart Citations

Predictors for Dilated Aorta in Repaired and Unrepaired Tetralogy of Fallot

Meguid¹,

Mahmoud²,

Mohammad³

2015

WJCD

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“…In addition, also genetic predisposition might contribute to aortic dilatation. It could, for instance, be shown that fibrillin-1 genetic mutations in TOF patients are associated with histologic abnormalities and larger aortic size [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Dimensions of the Ascending Aorta in Children and Adolescents with Repaired Tetralogy of Fallot Obtained by Cardiac Magnetic Resonance Angiography

Mende¹,

Gräfe²,

Dähnert³

et al. 2016

Thorac cardiovasc Surg

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Introduction Dilatation of the ascending aorta is a common finding in Tetralogy of fallot (TOF). We sought to provide aortic dimensions in children and adolescents after corrected TOF obtained by contrast-enhanced cardiacmagnetic-resonance angiography (CE-CMRA) that could serve as reference values. Materials and methods We enrolled 101 children and adolescents (56 male) with a median age of 10.9 years. All patients underwent CE-CMRA imaging using a 3-dimensional spoiled gradient-echo-sequence. Aortic diameters were measured at the level of the aortic valve (AV), aortic sinus (AS), sino-tubular junction (STJ) and the ascending aorta (AA) and compared with normal values obtained from literature. Sex-specific aortic dimensions are given as percentile curves as well as z scores. Furthermore CMR volumetric and functional parameters as well as clinical and anamnestic data were analyzed to identify parameters that are associated with aortic dilatation. Results Diameters for aortic size for males were 3.6 ? 16.6*BSA 0.5 at the AV level, 7.0 ? 19.5*BSA 0.5 at the AS level, 7.0 ? 14.4*BSA 0.5 at the STJ level and 7.3 ? 15.5*BSA 0.5 at the AA level. Diameters for females were 5.8 ? 14.1*BSA 0.5 at the AV level, 7.2 ? 17.6*BSA 0.5 at the AS level, 5.2 ? 15.4*BSA 0.5 at the STJ level and 2.0 ? 17.8*BSA 0.5 at the AA level. All diameters in TOF patients were larger compared with normal values. The postoperative interval and age at examination were the only parameters associated with aortic size at all measured levels. Conclusion We provide CE-CMRA data of aortic dimensions in children and adolescents after correction of TOF. Our data might be useful for an estimation of the ''normal'' aortic size in this patient cohort and can serve as a basis for future longitudinal studies adding prognostic data.

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