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Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery ALCAPA
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Aortic geometry and long-term outcome in patients with a repaired coarctation

Savine C S Minderhoud1,2, Rick van Montfoort1, Timion A Meijs3

  • 1Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands.

Open Heart
|May 28, 2024
PubMed

Insights

Repaired coarctation patients exhibit altered aortic morphology, with smaller and more tortuous aortas compared to controls. Left ventricular mass is linked to cardiovascular events, suggesting geometrical features aid long-term risk assessment.

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.
Abstract

Keywords:
Aneurysm, DissectingAortic AneurysmAortic CoarctationCardiac Imaging TechniquesComputed Tomography Angiography

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