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High prevalence of ascending aortic dilation in adults with repaired coarctation of the aorta

Part of: Echocardiography

Published online by Cambridge University Press:  18 February 2021

Daniel Rinnström Open the ORCID record for Daniel Rinnström [Opens in a new window] ,
Mikael Dellborg ,
Ulf Thilén ,
Peder Sörensson ,
Niels-Erik Nielsen ,
Christina Christersson  and
Bengt Johansson
Daniel Rinnström*
Affiliation:
Heart Centre and Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
Mikael Dellborg
Affiliation:
Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden
Ulf Thilén
Affiliation:
Department of Cardiology, Clinical Sciences, Lund University, Lund, Sweden
Peder Sörensson
Affiliation:
Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
Niels-Erik Nielsen
Affiliation:
Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
Christina Christersson
Affiliation:
Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden
Bengt Johansson
Affiliation:
Heart Centre and Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
*
Author for correspondence: Dr D. Rinnström, Heart Centre and Department of Public Health and Clinical Medicine, Umeå University, Sweden. Tel: +46 (0)70 3416796. E-mail: [email protected]
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Abstract

Background:

Ascending aortic dilation is a feared complication in adults with repaired coarctation of the aorta, as the condition is associated with life-threatening complications such as aortic dissection and rupture. However, the data are currently limited regarding factors associated with ascending aortic dilation in these patients.

Methods and results:

From the national register of congenital heart disease, 165 adult patients (≥ 18 years old) with repaired coarctation of the aorta, and echocardiographic data on aortic dimensions, were identified (61.2% male, mean age 35.8 ± 14.5 years). Aortic dilation (aortic diameters > 2 SD above reference mean) was found in 55 (33.3%) of the 165 included patients, and was associated with manifest aortic valve disease in univariable logistic regression analysis (OR 2.44, 95% CI [1.23, 4.83]).

Conclusions:

Aortic dilation is common post-repair of coarctation of the aorta, and is associated with manifest aortic valve disease and thus indirectly with the presence of a bicuspid aortic valve. However, no association was found between aortic dilation and age or blood pressure.

Keywords

CoAGUCHaortic dilation
Type
Original Article
Information
Cardiology in the Young , Volume 31 , Issue 6 , June 2021 , pp. 992 - 997
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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References

Crafoord, CNG. Congenital coarctation of the aorta and its surgical management. J Thorac Surg 1945; 14: 347–361.CrossRefGoogle Scholar
Guntheroth, WG. Coarctation of the aorta: long-term follow-up and prediction of outcome after surgical correction. Circulation 1990; 81: 1441.CrossRefGoogle ScholarPubMed
O’Sullivan, JJ, Derrick, G, Darnell, R. Prevalence of hypertension in children after early repair of coarctation of the aorta: a cohort study using casual and 24 hour blood pressure measurement. Heart 2002; 88: 163–166.CrossRefGoogle ScholarPubMed
Toro-Salazar, OH, Steinberger, J, Thomas, W, Rocchini, AP, Carpenter, B, Moller, JH. Long-term follow-up of patients after coarctation of the aorta repair. Am J Cardiol 2002; 89: 541–547.CrossRefGoogle ScholarPubMed
Lawrie, GM, DeBakey, ME, Morris, GC Jr, Crawford, ES, Wagner, WF, Glaeser, DH. Late repair of coarctation of the descending thoracic aorta in 190 patients. Results up to 30 years after operation. Arch Surg 1981; 116: 1557–1560.CrossRefGoogle ScholarPubMed
Cohen, M, Fuster, V, Steele, PM, Driscoll, D, McGoon, DC. Coarctation of the aorta. Long-term follow-up and prediction of outcome after surgical correction. Circulation 1989; 80: 840–845.CrossRefGoogle ScholarPubMed
Brown, ML, Burkhart, HM, Connolly, HM, et al. Coarctation of the aorta: lifelong surveillance is mandatory following surgical repair. J Am Coll Cardiol 2013; 62: 1020–1025.CrossRefGoogle ScholarPubMed
Canniffe, C, Ou, P, Walsh, K, Bonnet, D, Celermajer, D. Hypertension after repair of aortic coarctation--a systematic review. Int J Cardiol 2013; 167: 2456–2461.CrossRefGoogle ScholarPubMed
Choudhary, P, Canniffe, C, Jackson, DJ, Tanous, D, Walsh, K, Celermajer, DS. Late outcomes in adults with coarctation of the aorta. Heart 2015; 101: 1190–1195.CrossRefGoogle ScholarPubMed
Teo, LL, Cannell, T, Babu-Narayan, SV, Hughes, M, Mohiaddin, RH. 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.CrossRefGoogle ScholarPubMed
Ward, C. Clinical significance of the bicuspid aortic valve. Heart 2000; 83: 81–85.CrossRefGoogle ScholarPubMed
Luijendijk, P, Franken, RJ, Vriend, JW, et al. Increased risk for ascending aortic dilatation in patients with complex compared to simple aortic coarctation. Int J Cardiol 2013; 167: 827–832.CrossRefGoogle ScholarPubMed
von Kodolitsch, Y, Aydin, MA, Koschyk, DH, et al. Predictors of aneurysmal formation after surgical correction of aortic coarctation. J Am Coll Cardiol 2002; 39: 617–624.CrossRefGoogle ScholarPubMed
Rinnström, D, Engström, KG, Johansson, B. Subtypes of bicuspid aortic valves in coarctation of the aorta. Heart Vessels 2014; 29: 354–363.CrossRefGoogle ScholarPubMed
Covella, M, Milan, A, Totaro, S, et al. Echocardiographic aortic root dilatation in hypertensive patients: a systematic review and meta-analysis. J Hypertens 2014; 32: 1928–1935.CrossRefGoogle ScholarPubMed
Elefteriades, JA. Natural history of thoracic aortic aneurysms: indications for surgery, and surgical versus nonsurgical risks. Ann Thorac Surg 2002; 74: S1877–S1880.CrossRefGoogle ScholarPubMed
Thanassoulis, G, Yip, JW, Filion, K, et al. Retrospective study to identify predictors of the presence and rapid progression of aortic dilatation in patients with bicuspid aortic valves. Nature Clin Pract Cardiovasc Med 2008; 5: 821–828.CrossRefGoogle ScholarPubMed
Baumgartner, H, Bonhoeffer, P, De Groot, NM, et al. ESC Guidelines for the management of grown-up congenital heart disease (new version 2010). Eur Heart J 2010; 31: 2915–2957.Google Scholar
Ljungberg, J, Johansson, B, Engström, KG, et al. Traditional cardiovascular risk factors and their relation to future surgery for valvular heart disease or ascending aortic disease: a case-referent study. J Am Heart Assoc. 2017; 6.CrossRefGoogle ScholarPubMed
Du Bois, D, Du Bois, EF. A formula to estimate the approximate surface area if height and weight be known. 1916. Nutrition 1989; 5: 303–311.Google ScholarPubMed
Mirea, O, Maffessanti, F, Gripari, P, et al. Effects of aging and body size on proximal and ascending aorta and aortic arch: inner edge-to-inner edge reference values in a large adult population by two-dimensional transthoracic echocardiography. J Am Soc of Echocardiogr 2013; 26: 419–427.CrossRefGoogle Scholar
Jurcut, R, Daraban, AM, Lorber, A, et al. Coarctation of the aorta in adults: what is the best treatment? Case report and literature review. J Med Life 2011; 4: 189–195.Google ScholarPubMed
Braverman, AC, Guven, H, Beardslee, MA, Makan, M, Kates, AM, Moon, MR. The bicuspid aortic valve. Curr Probl Cardiol 2005; 30: 470–522.CrossRefGoogle ScholarPubMed
Rinnström, D, Dellborg, M, Thilén, U, et al. Hypertension in adults with repaired coarctation of the aorta. Am Heart J 2016; 181: 10–15.CrossRefGoogle ScholarPubMed
Rinnström, D, Dellborg, M, Thilén, U, et al. Poor blood pressure control in adults with repaired coarctation of the aorta and hypertension: a register-based study of associated factors. Cardiol Young 2017; 27: 1708–1715.CrossRefGoogle ScholarPubMed
Hiratzka, LF, Bakris, GL, Beckman, JA, et al. ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM guidelines for the diagnosis and management of patients with Thoracic Aortic Disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine. Circulation 2010; 121: e266–e369.Google Scholar
Pape, LA, Tsai, TT, Isselbacher, EM, et al. Aortic diameter >or = 5.5 cm is not a good predictor of type A aortic dissection: observations from the International Registry of Acute Aortic Dissection (IRAD). Circulation 2007; 116: 1120–1127.CrossRefGoogle Scholar
Simone, G, Chinali, M. Aortic root dimension and hypertension: a chicken-egg dilemma. Am J Hypertens 2008; 21: 489–490.CrossRefGoogle ScholarPubMed