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Identifying Predictors for Hypoplastic Aortic Arch (HAA) in Pediatric Patients with Complex Coarctation of the Aorta

Ying Lyu1, Lu Tian1, Bin Qin1

  • 1Department of Radiology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders. Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China.

Current Medical Imaging
|March 18, 2024
PubMed

Insights

Hypoplastic ascending aorta (HAA) is linked to severe coarctation of the aorta (CoA) and other cardiovascular issues in children. Identifying HAA can improve diagnosis and treatment for complex CoA patients.

Area of Science:

  • Cardiovascular Medicine
  • Pediatric Cardiology
  • Medical Imaging

Background:

  • Hypoplastic ascending aorta (HAA) is a significant risk factor in patients with complex coarctation of the aorta (CoA).
  • Understanding the associations between HAA and other cardiovascular factors is crucial for managing complex CoA.

Purpose of the Study:

  • To explore the relationship between HAA and other cardiovascular factors in children with complex CoA.
  • To identify risk factors associated with HAA in this patient population.

Main Methods:

  • Retrospective analysis of 103 patients with complex CoA, diagnosed via CT angiography and echocardiography.
  • Measurement of aortic diameter at six levels; severe coarctation defined by coarctation site to diaphragmatic level ratio (CDR) < 50%.
  • Assessment of correlations and logistic regression to identify HAA risk factors.

Main Results:

  • The HAA group (48 patients) showed higher incidences of patent ductus arteriosus (PDA), severe coarctation (CDR < 50%), and collateral arteries compared to the non-HAA group (55 patients).
  • Collateral arteries were identified as significant risk factors for aortic arch hypoplasia, severe coarctation, and left heart dysfunction.
  • Aortic arch size correlated positively with age and negatively with severe coarctation, VSD, collateral arteries, and left heart dysfunction.

Conclusions:

  • HAA is prevalent in complex CoA patients and associated with critical cardiovascular anomalies.
  • Findings enhance understanding of HAA's role in complex CoA, potentially improving diagnostic and therapeutic strategies.
Abstract

Keywords:
aortic diseaseschildrencoarctation of aortacomputed tomography.congenital heart diseasehypoplastic aortic arch

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