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.
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1. Allen HD Driscoll DJ Shaddy RE Feltes TF. Moss and Adams’ Heart Disease in Infants Children and Adult including the Fetus and Young Adult Eighth ed. Philadelphia: Lippincott Williams & Wilkins 2013; vol. 1 and 2.
2. Huang F Chen Q Huang WH Wu H Li WC Lai QQ. Diagnosis of Congenital Coarctation of the Aorta and Accompany Malformations in Infants by Multi-Detector Computed Tomography Angiography and Transthoracic Echocardiography: A Chinese Clinical Study. Med Sci Monit. 2017;23:2308-2314.
3. Shih MC Tholpady A Kramer CM et al. Surgical and endovascular repair of aortic coarctation: normal findings and appearance of complications on CT angiography and MR angiography. Am J Roentgenol. 2006;187:W302-W312.
4. Rosenthal E. Coarctation of the aorta from fetus to adult: curable condition or lifelong disease process? Heart. 2005;91:1495-1502.
5. Van der Linde D Konings EE Slager MA et al. Birth prevalence of congenital heart disease worldwide: a systematic review and meta-analysis. J Am Coll Cardiol. 2011;58:2241-2247.
6. Hoffman JIE Kaplan S Liberthson RR. Prevalence of congenital heart disease. Am Heart J. 2004;147:425-439.
7. Peng DM Punn R Maeda K Selamet Tierney ES. Diagnosing Neonatal Aortic coarctation in the setting of Patent Ductus Arteriosus. Ann Thorac Surg. 2016;101:1005-1011.
8. Teo LL Cannell T Babu-Narayan SV et al. Prevalence of associated cardiovascular abnormalities in 500 patients with aortic coarctation referred for cardiovascular magnetic resonance imaging to a tertiary center. Pediatr Cardiol. 2011;32:1120-1127.
9. Chang RK Gurvitz M Rodriguez S. Missed diagnosis of critical congenital heart disease. Arch Pediatr Adolesc Med. 2008;162:969-974.
10. Massin MM Deessy H. Delayed recognition of congenital heart disease. Postgrad Med J. 2006;82:468-470.
11. Rudolph AM. Congenital diseases of the heart: Clinical-physiological considerations. Chichester: Wiley-Blackwell 2009.
12. Ramaciotti C Chin AJ. Noninvasive diagnosis if coarctation of the aorta in the presence of patent ductus arteriosus. Am Heart J. 1993;125:179-185.
13. Jaquiss RDB Frommelt PC. Carotid-subclavian artery index: new echocardiographic index to detect coarctation in neonates and infants. Invited commentary. Ann Thorac Surg. 2005;80:1657-1658.
14. Togănel R. Abordarea diagnostică și terapeutică a afecțiunilor cardiace congenitale la copil. Tîrgu Mureș: University Press 2008; p. 171-178.
15. Espinola-Zavaleta N Muñoz-Castellanos L Kuri-Nivon M Keirns C. Aortic obstruction: anatomy and echocardiography. Cardiovas Ultrasound. 2006;4:36.
16. Suciu H. Patologie cardiocirculatorie neonatală. Tîrgu Mureș: University Press 2016; p. 187-188.