Aortic geometry and long-term outcome in patients with a repaired coarctation

Area of Science:

• Cardiovascular Imaging
• Medical Engineering
• Clinical Cardiology

Background:

• Coarctation of the aorta is a congenital heart defect requiring surgical repair.
• Long-term outcomes after coarctation repair are influenced by aortic morphology.
• Understanding aortic shape changes is crucial for risk stratification in repaired coarctation patients.

Purpose of the Study:

• To compare aortic morphology between repaired coarctation patients and controls.
• To identify aortic morphological risk factors for hypertension and cardiovascular events (CVEs) in coarctation patients.

Main Methods:

• Utilized computed tomography angiography (CTA) or magnetic resonance angiography (MRA) for 3D aortic reconstruction.
• Employed statistical shape modeling to analyze geometrical characteristics.
• Assessed associations with hypertension and CVEs using multivariable logistic and Cox regression, respectively.

Main Results:

• Repaired coarctation patients presented with smaller aortic arch dimensions and increased torsion and curvature compared to controls.
• No specific geometrical characteristics were associated with baseline hypertension.
• Left ventricular mass was independently associated with CVEs, and aortic tortuosity showed a trend towards significance.

Conclusions:

• Repaired coarctation patients have distinct aortic arch morphology, characterized by smaller dimensions and increased tortuosity.
• Left ventricular mass and aortic geometrical features are important for long-term risk assessment in this population.