Daniela Toma, Simina-Elena Rusu, Cristina Blesneac, Marian Pop and Rodica Togănel
Background: Critical aortic coarctation is defined as the severe narrowing of the isthmic aortic lumen, representing a neonatal cardiac emergency, part of the congenital heart diseases with duct-dependent systemic circulation.
Aim of the study: To assess the correlation between transthoracic echocardiography and computed tomography angiography (CTA) in the measurement of aortic diameters in a group of newborns diagnosed with duct-dependent aortic coarctation and/or associated hypoplastic aortic arch.
Material and method: We performed a retrospective study on neonates diagnosed with duct-dependent aortic coarctation and/or associated hypoplastic aortic arch between January 1, 2015 and March 1, 2017. The studied parameters were diameters of the aorta at the level of the aortic annulus, coronary sinuses, sinotubular junction, ascending aorta, proximal and distal aortic arch, and the aortic isthmus. Measurements were obtained by transthoracic echocardiography and thoracic CTA.
Results: Fifteen newborns diagnosed with duct-dependent aortic coarctation and/or associated hypoplastic aortic arch were included in this study. There was no statistically significant difference between the two imaging methods, the T test highlighting differences only between the measurements of the aortic annulus (p <0.016) and coronary sinuses (p <0.008). The patients included in the study associated other cardiovascular abnormalities: persistent ductus arteriosus (100%), atrial septal defect (100%), aortic arch hypoplasia (80%), bicuspid aortic valve (73.3%).
Conclusions: These methods reveal important information on the anatomy of the cardiovascular malformation and its impact on the clinical and paraclinical status of the patient, being fundamental for establishing an optimal therapeutic approach.
Cristina Blesneac, Carmen Corina Şuteu, Marian Pop and Rodica Togănel
Unilateral pulmonary artery agenesis is a rare congenital anomaly, that may develop in isolation, or in association with other congenital cardiovascular anomalies, such as tetralogy of Fallot, septal defects, right-sided aortic arch, or pulmonary atresia. Left-sided pulmonary artery agenesis is less frequent than the right-sided one. Diagnosis of unilateral pulmonary artery agenesis can be difficult. We report the case of a 15 year-old boy who presented with reduced exercise tolerance, shortness of breath and cyanosis. He was diagnosed with left pulmonary artery agenesis, associated with subaortic-ventricular septal defect, right-sided aortic arch, and severe pulmonary arterial hypertension (PAH), that precluded the surgical repair. Pulmonary vasodilator therapy was initiated in this case. The mortality rate of this rare anomaly is high due to its complications. It is essential to establish an early and correct diagnosis, in order to provide adequate treatment and prevent complications in this disease.
Simina-Elena Rusu, Daniela Toma, Cristina Blesneac, Laura Matei, Claudiu Ghiragosian and Rodica Togănel
period: a comparative study with the adult animal. Pediatr Res. 1979;13;910-915.
13. Thornburg KI, Morton MJ. Filling and arterial pressure as determinants of RV stroke volume in the sheep fetus. Am J Physiol. 1983;244:H656.
14. Morrow Wr, Huhta JC, Murphy DJ Jr, McNamara DG. Quantitative morphology of the aorticarch in neonatal coarctation. J AM Coll Cardiol. 1986;8:616-620.
. Coarctation of Aorta. Current Science Inc. Current Cardiology Reports. 2005;7:425-34.
12. Karatza AA, Wolfenden JL, Taylor MJO et al. Influence of twintwin transfusion syndrome on fetal cardiovascular structure and function: prospective case-control study of 136 monochorionic twin pregnancies. Heart. 2002;88:271-7.
13. Boom van den J, Battin M, Hornung T. Twin-twin transfusion syndrome, coarctation of the aorta and hypoplastic aorticarch: a case series report. Paediatr Child Health. 2010;46:76-9.
14. Cloherty JP. Multiple Birth, in Cloherty JP, Eichenwald EC, Stark