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Assessment of the structure and function of the aorta by echocardiography

Published online by Cambridge University Press:  02 February 2017

Anitha Parthiban  and
Girish Shirali
Anitha Parthiban*
Affiliation:
Ward Family Heart Center, Children’s Mercy Hospital, Kansas City, Missouri, United States of America
Girish Shirali
Affiliation:
Ward Family Heart Center, Children’s Mercy Hospital, Kansas City, Missouri, United States of America
*
Correspondence to: A. Parthiban, MD, Children’s Mercy Hospital, 2401 Gillham Road, Kansas City, MO 64108, United States of America. Tel: +816 234 3255; Fax: 816 302 9987; E-mail: [email protected]
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Abstract

Echocardiography is the primary modality for imaging the aorta for the diagnosis and serial evaluation of pathological conditions. In this article, we review the methodology for optimal echocardiographic imaging of the various segments of the aorta and discuss abnormalities of the aorta including stenosis, dilation including aortopathy and sinus of Valsalva aneurysms, and fistulous communications involving the ascending aorta including aortoventricular tunnel and ruptured sinus of Valsalva aneurysm. We review novel echocardiographic measurements of aortic functional properties of the aorta such as elasticity and stiffness, and review the literature on the potential additive value of such measurements for structural assessment alone. Finally, we discuss the limitations of echocardiography in the precise and optimal imaging of the aorta.

Keywords

Supravalvar aortic stenosissinus of Valsalva aneurysmaortoventricular tunnelechocardiographic imaging of the aortaaortic stiffness
Type
Review Articles
Information
Cardiology in the Young , Volume 26 , Special Issue 8: HeartWeek 2016 , December 2016 , pp. 1543 - 1552
Copyright
© Cambridge University Press 2017 

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References

1. Goldstein, SA, Evangelista, A, Abbara, S, et al. Multimodality imaging of diseases of the thoracic aorta in adults: from the American Society of Echocardiography and the European Association of Cardiovascular Imaging: endorsed by the Society of Cardiovascular Computed Tomography and Society for Cardiovascular Magnetic Resonance. J Am Soc Echocardiogr 2015; 28: 119–182.Google Scholar
2. Lopez, L, Colan, SD, Frommelt, PC, et al. Recommendations for quantification methods during the performance of a pediatric echocardiogram: a report from the Pediatric Measurements Writing Group of the American Society of Echocardiography Pediatric and Congenital Heart Disease Council. J Am Soc Echocardiogr 2010; 23: 465–495.Google Scholar
3. Pettersen, MD, Du, W, Skeens, ME, Humes, RA. Regression equations for calculation of z scores of cardiac structures in a large cohort of healthy infants, children, and adolescents: an echocardiographic study. J Am Soc Echocardiogr 2008; 21: 922–934.CrossRefGoogle Scholar
4. Sluysmans, T, Colan, SD. Theoretical and empirical derivation of cardiovascular allometric relationships in children. J Appl Physiol 2005; 99: 445–457.Google Scholar
5. Kharwar, RB, Narain, VS, Sethi, R. Real time three-dimensional transthoracic echocardiography of ruptured left sinus of Valsalva aneurysm to left ventricle. Echocardiography 2013; 30: E331–E335.Google Scholar
6. Vijay, SK, Narain, VS, Sethi, R, Chandra, S, Puri, A. Live three-dimensional transthoracic echocardiography of giant aorto-right ventricular tunnel. Eur Heart J Cardiovasc Imaging 2013; 14: 86.CrossRefGoogle ScholarPubMed
7. Chang, CY, Hsiung, MC, Tsai, SK, et al. Live three-dimensional transesophageal echocardiography in an unusual case of aorto-left ventricular tunnel with a large interventricular septal aneurysm. Echocardiography 2011; 28: E12–E15.Google Scholar
8. Merla, G, Brunetti-Pierri, N, Piccolo, P, Micale, L, Loviglio, MN. Supravalvular aortic stenosis: elastin arteriopathy. Circ Cardiovasc Genet 2012; 5: 692–696.CrossRefGoogle ScholarPubMed
9. Stamm, C, Friehs, I, Ho, SY, Moran, AM, Jonas, RA, del Nido, PJ. Congenital supravalvar aortic stenosis: a simple lesion? Eur J Cardiothorac Surg 2001; 19: 195–202.CrossRefGoogle ScholarPubMed
10. Dayan, J, Sett, S, Krishnan, U. Silent rupture of sinus of Valsalva aneurysm: a refutation of the Okham’s razor principle. Cardiol Young 2011; 21: 713–715.Google Scholar
11. Math, RS, Saxena, A, Chakraborty, P, Reddy, SM, Bisoi, A. An unusual case of dissecting aneurysms involving both coronary sinuses of Valsalva. J Am Soc Echocardiogr 2010; 23: 457–459 458 e.Google Scholar
12. Lahrouchi, N, Rammeloo, LA, Koolbergen, DR, Hruda, J. Ruptured aneurysm of the right coronary sinus of Valsalva in a child with down syndrome. Cardiol Young 2014; 24: 376–378.Google Scholar
13. Vijayalakshmi, IB, Devananda, NS, Chitra, N. A patient with aneurysms of both aortic coronary sinuses of Valsalva obstructing both ventricular outflow tracts. Cardiol Young 2009; 19: 537–539.CrossRefGoogle ScholarPubMed
14. Cheng, TO, Yang, YL, Xie, MX, et al. Echocardiographic diagnosis of sinus of Valsalva aneurysm: a 17-year (1995–2012) experience of 212 surgically treated patients from one single medical center in China. Int J Cardiol 2014; 173: 33–39.Google Scholar
15. Mithani, AA, Polimenakos, AC, Santucci, BA. Ruptured sinus of Valsalva found incidentally in a patient with Tetralogy of Fallot. Pediatr Cardiol 2013; 34: 1914–1917.Google Scholar
16. Nakamura, Y, Aoki, M, Hagino, I, Koshiyama, H, Fujiwara, T, Nakajima, H. Case of congenital aneurysm of sinus of Valsalva with common arterial trunk. Ann Thorac Surg 2014; 97: 710–712.Google Scholar
17. Thankavel, PP, Lemler, MS, Ramaciotti, C. Unruptured sinus of valsalva aneurysm in a neonate with hypoplastic left heart syndrome: echocardiographic diagnosis and features. Echocardiography 2014; 31: E85–E87.Google Scholar
18. McKay, R. Aorto-ventricular tunnel. Orphanet J Rare Dis 2007; 2: 41.Google Scholar
19. Mahle, WT, Kreeger, J, Silverman, NH. Echocardiography of the aortopulmonary window, aorto-ventricular tunnels, and aneurysm of the sinuses of Valsalva. Cardiol Young 2010; 20 (Suppl 3): 100–106.CrossRefGoogle ScholarPubMed
20. Deshpande, SR, Fyfe, DA. Aorto-right atrial tunnel: fetal heart failure, diagnosis, and treatment. Pediatr Cardiol 2010; 31: 299–300.Google Scholar
21. Vida, VL, Bottio, T, Stellin, G. An unusual case of aorto-left ventricular tunnel. Cardiol Young 2004; 14: 203–205.Google Scholar
22. Singh, SK, Dwivedi, SK, Kumar, A, et al. Aneurysmal aorto-right ventricular tunnel. Ann Thorac Surg 2012; 93: e21–e22.Google Scholar
23. Ziesenitz, VC, Gorenflo, M, Loukanov, T. Repair of an aorto-right ventricular tunnel in a newborn. Cardiol Young 2016; 26: 147–148.CrossRefGoogle ScholarPubMed
24. Jureidini, SB, de Mello, D, Nouri, S, Kanter, K. Aortico-right ventricular tunnel and critical pulmonary stenosis: diagnosis by two-dimensional and Doppler echocardiography and angiography. Pediatr Cardiol 1989; 10: 99–103.Google Scholar
25. Hruda, J, Hazekamp, MG, Sobotka-Plojhar, MA, Ottenkamp, J. Repair of aorto-right ventricular tunnel with pulmonary stenosis and an anomalous origin of the left coronary artery. Eur J Cardiothorac Surg 2002; 21: 1123–1125.Google Scholar
26. Francois, K. Aortopathy associated with congenital heart disease: a current literature review. Ann Pediatr Cardiol 2015; 8: 25–36.Google Scholar
27. Selamet Tierney, ES, Levine, JC, Chen, S, et al. Echocardiographic methods, quality review, and measurement accuracy in a randomized multicenter clinical trial of Marfan syndrome. J Am Soc Echocardiogr 2013; 26: 657–666.Google Scholar
28. Carlson, M, Airhart, N, Lopez, L, Silberbach, M. Moderate aortic enlargement and bicuspid aortic valve are associated with aortic dissection in Turner syndrome: report of the international turner syndrome aortic dissection registry. Circulation 2012; 126: 2220–2226.Google Scholar
29. Fikar, CR. Acute aortic dissection in children and adolescents: diagnostic and after-event follow-up obligation to the patient and family. Clin Cardiol 2006; 29: 383–386.CrossRefGoogle Scholar
30. Baliga, RR, Nienaber, CA, Bossone, E, et al. The role of imaging in aortic dissection and related syndromes. JACC Cardiovasc Imaging 2014; 7: 406–424.Google Scholar
31. Oulego-Erroz, I, Alonso-Quintela, P, Mora-Matilla, M, Gautreaux Minaya, S, Lapena-Lopez de Armentia, S. Ascending aorta elasticity in children with isolated bicuspid aortic valve. Int J Cardiol 2013; 168: 1143–1146.Google Scholar
32. Pees, C, Michel-Behnke, I. Morphology of the bicuspid aortic valve and elasticity of the adjacent aorta in children. Am J Cardiol 2012; 110: 1354–1360.Google Scholar
33. Vogt, M, Kuhn, A, Baumgartner, D, et al. Impaired elastic properties of the ascending aorta in newborns before and early after successful coarctation repair: proof of a systemic vascular disease of the prestenotic arteries? Circulation 2005; 111: 3269–3273.Google Scholar
34. Chen, RH, Wong, SJ, Wong, WH, Cheung, YF. Arterial mechanics at rest and during exercise in adolescents and young adults after arterial switch operation for complete transposition of the great arteries. Am J Cardiol 2014; 113: 713–718.Google Scholar
35. Vitarelli, A, Conde, Y, Cimino, E, et al. Aortic wall mechanics in the Marfan syndrome assessed by transesophageal tissue Doppler echocardiography. Am J Cardiol 2006; 97: 571–577.Google Scholar
36. Vitarelli, A, Conde, Y, Cimino, E, et al. Assessment of ascending aorta distensibility after successful coarctation repair by strain Doppler echocardiography. J Am Soc Echocardiogr 2008; 21: 729–736.Google Scholar
37. Teixeira, R, Moreira, N, Baptista, R, et al. Circumferential ascending aortic strain and aortic stenosis. Eur Heart J Cardiovasc Imaging 2013; 14: 631–641.Google Scholar
38. Nejatian, A, Yu, J, Geva, T, White, MT, Prakash, A. Aortic measurements in patients with aortopathy are larger and more reproducible by cardiac magnetic resonance compared with echocardiography. Pediatr Cardiol 2015; 36: 1761–1773.Google Scholar
39. van der Linde, D, Rossi, A, Yap, SC, et al. Ascending aortic diameters in congenital aortic stenosis: cardiac magnetic resonance versus transthoracic echocardiography. Echocardiography 2013; 30: 497–504.Google Scholar
40. Goldstein, SA, Evangelista, A, Abbara, S, et al. Multimodality imaging of diseases of the aorta in adults. J Am Soc Echocardiogr 2015; 28: 119–182.Google Scholar

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