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Does the z-score value of the abdominal aorta predict recoarctation in an infant?

Canan Ayabakan1, Köksal Binnetoğlu, Özlem Sarisoy

  • 1Başkent University İstanbul Research Hospital, İstanbul, Turkey. cayabakan@yahoo.com

Congenital Heart Disease
|March 2, 2013
PubMed

Insights

Balloon angioplasty for coarctation of the aorta is controversial due to restenosis. An abdominal aorta z-score of 0.42 can help identify infants at lower risk of recoarctation after this procedure.

Area of Science:

  • Pediatric Cardiology
  • Cardiovascular Surgery
  • Medical Imaging

Background:

  • Coarctation of the aorta (CoA) is a congenital heart defect requiring intervention.
  • Balloon angioplasty (BAP) and surgical repair are primary treatment options for CoA.
  • Restenosis, or recoarctation, remains a significant concern after intervention.

Purpose of the Study:

  • To evaluate left ventricular dimensions and aortic arch z-scores in infants with CoA.
  • To identify risk factors predicting recoarctation after BAP or surgery for CoA.

Main Methods:

  • Retrospective evaluation of 44 infants (2 days-24 months) with CoA between 2007-2011.
  • Measurement of left ventricular dimensions, systolic functions, and various aortic segments with z-score determination.
  • Analysis of recoarctation rates and associated risk factors, including abdominal aorta z-scores.

Main Results:

  • 14 out of 33 (42%) infants who underwent successful primary BAP experienced recoarctation.
  • Infants in the recoarctation group had significantly lower abdominal and transverse aorta z-scores.
  • An abdominal aorta z-score of 0.42 demonstrated 88.9% sensitivity and 53.8% specificity for predicting recoarctation.

Conclusions:

  • Despite high restenosis rates, BAP is a viable option for native coarctation.
  • An abdominal aorta z-score cutoff of 0.42 can aid in selecting patients for primary BAP.
  • Utilizing this z-score may help reduce the incidence of recoarctation following BAP for CoA.
Abstract

Keywords:
Balloon AngioplastyInfantRecoarctation

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