Iran University of Medical Sciences, Tehran, Iran.
Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
Cardiol Young. 2024 May;34(5):1128-1130. doi: 10.1017/S1047951124000143. Epub 2024 Feb 27.
Tetralogy of Fallot is the most prevalent cyanotic CHD. With the advent of advanced surgical methods, the majority of tetralogy of Fallot patients reach adulthood. However, many need re-intervention for the residual anomalies including residual right ventricular outflow obstruction, pulmonary regurgitation, residual ventricular septal defects, and progressive aortic dilatation. Aortic dilation could lead to aortic regurgitation or dissection requiring surgical correction. In the current study, we aimed to determine the prevalence and outcomes of aortic root dilatation in adults with repaired tetralogy of Fallot in our tertiary care centre.
In this retrospective study, 730 consecutive patients with history of repaired tetralogy of Fallot were included. Aortic diameter at the level of annulus, the sinus of Valsalva, sinotubular junction, and the ascending aorta as measured by echocardiography were evaluated. Prevalence of outcomes necessitating re-intervention including aortic regurgitation and dissection were recorded.
The mean size of annulus, sinus of Valsalva, sinotubular-junction, and ascending aorta in the latest available echocardiography of patients were 2.4+/-0.4 cm, 3.3+/-0.5 cm, 2.9+/-0.5cm, and 3.2+/-0.5cm, respectively. Prevalence of dilatation of sinus of Valsalva, dilation of Ascending aorta, sinotubular-junction, and aortic annulus was 28.7%, 21%, 8.3%, and 1 %, respectively. Five patients had severe aortic regurgitation (0.6%) and underwent surgical repair. One of these patients presented with acute aortic dissection.
Aortic dilation is common in tetralogy of Fallot but prevalence of redo surgery for aortic dilation, regurgitation, and adverse events including acute dissection is low.
法洛四联症是最常见的发绀型先天性心脏病。随着先进的外科治疗方法的出现，大多数法洛四联症患者能够进入成年期。然而，许多患者仍需要再次干预，以解决残留的异常，包括残余右心室流出道梗阻、肺动脉瓣反流、残余室间隔缺损和主动脉进行性扩张。主动脉扩张可能导致主动脉瓣反流或夹层，需要手术矫正。在本研究中，我们旨在确定在我们的三级医疗中心，接受修复的法洛四联症患者中，主动脉根部扩张的患病率和结局。
这是一项回顾性研究，纳入了 730 例连续的既往接受过法洛四联症修复术的患者。通过超声心动图评估主动脉瓣环水平、主动脉窦、窦管交界和升主动脉的直径。记录需要再次干预的结局，包括主动脉瓣反流和夹层。
在最近一次可获得的超声心动图中，患者的主动脉瓣环、主动脉窦、窦管交界和升主动脉的平均大小分别为 2.4+/-0.4cm、3.3+/-0.5cm、2.9+/-0.5cm 和 3.2+/-0.5cm。主动脉窦扩张、升主动脉扩张、窦管交界扩张和主动脉瓣环扩张的患病率分别为 28.7%、21%、8.3%和 1%。5 例患者（0.6%）有严重的主动脉瓣反流，需要手术修复。其中 1 例患者出现急性主动脉夹层。
主动脉扩张在法洛四联症中很常见，但需要再次手术治疗主动脉扩张、反流和不良事件（包括急性夹层）的患病率较低。
