Siripornpitak Suvipaporn, Sriprachyakul Apichaya, Wongmetta Saruntorn, Samankatiwat Piya, Mokarapong Pirapat, Wanitkun Suthep
Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama 6 Road, Phayatai, Ratchathewi, Bangkok, 10400, Thailand.
Division of Thoracic Surgery, Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama 6 Road, Phayatai, Ratchathewi, Bangkok, 10400, Thailand.
Jpn J Radiol. 2021 Aug;39(8):774-782. doi: 10.1007/s11604-021-01119-3. Epub 2021 Apr 18.
To determine the prevalence and degree of aortic dilatation (A), severity of aortic stiffness (A), factors for A and level of aortic root most sensitive to A in patients with repaired tetralogy of Fallot (rTOF).
269 patients with rTOF (mean age 14.9 ± standard deviation 5.0 years) were analyzed for A at annulus, sinus, sinotubular junction, and ascending aorta (aAo). Aortic size index was graded as Z score < 2, 2-2.99, 3-4.99 and ≥ 5. Aortic distensibility (aA) was categorized according to 4 aortic levels and dilatation severity. Factors for A and level of aortic root most sensitive to A were analyzed.
Sinus and aAo were the two most common sites of A, with a prevalence of 84% and 76%, respectively. A decreased aA was found (mean 5.38 ± 1.79 10 mmHg). aA only declined significantly at the sinus level (p = 0.009). Male sex, age-at-repair and aortic regurgitation were significant factors for A, with male sex as the strongest factor (odds ratio 2.94). There was a significant decline in aA at sinus level (p = 0.002) as A progressed.
We observed a high prevalence of A and A in patients with rTOF. Male sex is the strongest factor for A. The sinus is the most sensitive area for determining a negative aA effect.
确定法洛四联症修补术后（rTOF）患者主动脉扩张（A）的患病率和程度、主动脉僵硬度（A）的严重程度、A的相关因素以及对A最敏感的主动脉根部水平。
分析269例rTOF患者（平均年龄14.9±标准差5.0岁）在瓣环、窦部、窦管交界和升主动脉（aAo）处的A情况。主动脉大小指数分为Z评分＜2、2 - 2.99、3 - 4.99和≥5。根据4个主动脉水平和扩张严重程度对主动脉扩张性（aA）进行分类。分析A的相关因素以及对A最敏感的主动脉根部水平。
窦部和aAo是A最常见的两个部位，患病率分别为84%和76%。发现aA降低（平均5.38±1.79 10 mmHg）。仅在窦部水平aA显著下降（p = 0.009）。男性、修补时年龄和主动脉瓣反流是A的显著相关因素，其中男性是最强因素（比值比2.94）。随着A进展，窦部水平aA显著下降（p = 0.002）。
我们观察到rTOF患者中A和A的患病率较高。男性是A的最强相关因素。窦部是确定aA负效应最敏感的区域。
