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Cineangiographic aortic dimensions in normal children
Kalyani R Trivedi1, Jorge L Pinzon, Brian W McCrindle
1Department of Pediatrics, The Hospital for Sick Children, University of Toronto School of Medicine, Ontario, Canada.
Insights
This study establishes normal thoracic aorta dimensions in children using cineangiograms. These findings aid in diagnosing aortic disease and evaluating treatment outcomes in pediatric patients.
Area of Science:
- Pediatric Cardiology
- Medical Imaging
- Thoracic Surgery
Background:
- Accurate knowledge of normal aortic dimensions is crucial for managing pediatric aortic diseases.
- Previous studies have not comprehensively defined normal aortic dimensions across a wide pediatric age range.
Purpose of the Study:
- To define normal dimensions of the thoracic aorta in children.
- To establish reference ranges for various aortic segments.
- To provide data for identifying thoracic aortic abnormalities in childhood.
Main Methods:
- Retrospective review of clinical data and aortic cineangiograms from 167 children without aortic disease.
- Measurement of systolic dimensions at multiple aortic levels (ascending, descending, arch, isthmus, diaphragm).
- Regression analysis correlating aortic dimensions with height to establish normal ranges and confidence limits.
Main Results:
- Established normal ranges for all measured thoracic aortic segments.
- Height was identified as the primary biophysical parameter correlating with aortic dimensions.
- Data applicable to children aged 0.01 to 14.95 years.
Conclusions:
- The study provides essential normative data for the pediatric thoracic aorta.
- These reference ranges will assist in the early detection of aortic abnormalities.
- The findings support improved assessment of intervention outcomes in pediatric aortic disease.
Abstract:
Knowledge of normal aortic dimensions is important in the management of children with aortic disease. So as to define such dimensions, we undertook a retrospective review of clinical data and aortic cineangiograms from 167 subjects without aortic disease having a mean age of 3.67 years, with a range from 0.01 to 14.95 years. Amongst the patients, 56 were without detectable cardiac lesions, 66 patients had mild pulmonary stenosis, 30 were seen with Kawasaki disease, and 15 with small interatrial defects within the oval fossa. Aortograms were available in all. No patient had any hemodynamic derangement that would have affected the aorta during intrauterine life or childhood. Systolic dimensions were measured in the ascending and descending aorta at the level of the carina, at the transverse aortic arch distal to the brachiocephalic, of the left common carotid artery at its origin, at the transverse aortic arch distal to the left common carotid artery, at the aortic isthmus, and of the aorta at the level of the diaphragm. A regression analysis model was used to establish the range of predicted normal values, with their confidence limits, standardizing the values to height as the biophysical parameter having the highest correlation to aortic dimensions. Normal ranges were established for all the levels of measurement. The data should prove useful in identifying abnormalities of the thoracic aorta during childhood, and when assessing the outcomes of interventions.