Gong Ting, Zhang Feiyan, Feng Lingxin, Zhu Xu, Deng Dan, Ran Tingting, Li Liling, Kong Li, Sun Liqun, Ji Xiaojuan
Department of Ultrasound, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
Department of Ultrasound, Children's Hospital of Chongqing Medical University, Chongqing, China.
Front Cardiovasc Med. 2023 Jul 24;10:1078038. doi: 10.3389/fcvm.2023.1078038. eCollection 2023.
Coarctation of the aorta (CoA) is a common congenital cardiovascular malformation, and improvements in the diagnostic process for surgical decision-making are important. We sought to compare the diagnostic accuracy of transthoracic echocardiography (TTE) with computed tomographic angiography (CTA) to diagnose CoA.
We retrospectively reviewed 197 cases of CoA diagnosed by TTE and CTA and confirmed at surgery from July 2009 to August 2019.
The surgical findings confirmed that 19 patients (9.6%) had isolated CoA and 178 (90.4%) had CoA combined with other congenital cardiovascular malformations. The diagnostic accuracy of CoA by CTA was significantly higher than that of TTE ( = 6.52, = 0.01). In contrast, the diagnostic accuracy of TTE for associated cardiovascular malformations of CoA was significantly higher than that of CTA ( = 15.36, < 0.0001). Infants and young children had more preductal type of CoA, and PDA was the most frequent cardiovascular lesion associated with CoA. The pressure gradient was significantly decreased after the first operation, similar at 6 months, 1 year, and 3 years follow-ups by TTE.
CTA is more accurate as a clinical tool for diagnosing CoA; however, TTE with color Doppler can better identify associated congenital cardiovascular malformations. Therefore, combining TTE and CTA would benefit clinical evaluation and management in patients suspected of CoA. TTE was valuable for post-operation follow-up and clinical management.
主动脉缩窄（CoA）是一种常见的先天性心血管畸形，改善手术决策的诊断过程很重要。我们旨在比较经胸超声心动图（TTE）与计算机断层血管造影（CTA）诊断CoA的准确性。
我们回顾性分析了2009年7月至2019年8月期间经TTE和CTA诊断并经手术证实的197例CoA病例。
手术结果证实，19例（9.6%）为孤立性CoA，178例（90.4%）为CoA合并其他先天性心血管畸形。CTA诊断CoA的准确性显著高于TTE（ = 6.52， = 0.01）。相比之下，TTE诊断CoA相关心血管畸形的准确性显著高于CTA（ = 15.36， < 0.0001）。婴幼儿动脉导管前型CoA较多，动脉导管未闭（PDA）是与CoA相关最常见的心血管病变。首次手术后压力阶差显著降低，TTE在6个月、1年和3年随访时相似。
CTA作为诊断CoA的临床工具更准确；然而，彩色多普勒TTE能更好地识别相关先天性心血管畸形。因此，联合使用TTE和CTA将有助于疑似CoA患者的临床评估和管理。TTE对术后随访和临床管理有价值。
