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Normative angiographic data relating to the dimensions of the aorta and pulmonary trunk in children and adolescents

Published online by Cambridge University Press:  22 April 2005

Spyridon Rammos
Affiliation:
Department of Paediatric Cardiology, Onassis Cardiac Surgery Centre, Athens, Greece
Sotiria C. Apostolopoulou
Affiliation:
Department of Paediatric Cardiology, Onassis Cardiac Surgery Centre, Athens, Greece
Hans H. Kramer
Affiliation:
Department of Paediatric Cardiology, University of Kiel, Kiel, Germany
Reiner Kozlik-Feldmann
Affiliation:
Department of Paediatric Cardiology, University of Munich, Munich, Germany
Andreas Heusch
Affiliation:
Department of Paediatric Cardiology, University of Duesseldorf, Duesseldorf, Germany
Cleo V. Laskari
Affiliation:
Department of Paediatric Cardiology, Onassis Cardiac Surgery Centre, Athens, Greece
Constantine Anagnostopoulos
Affiliation:
Department of Cardiac Surgery, St. Luke's Roosevelt Hospital Centre, Columbia University, New York, United States of America and University of Athens, Athens, Greece

Abstract

Background: Definition of normative data of the great arteries from neonatal to adult ages may aid in assessment of the growth of cardiovascular structures, thus guiding the timing and type of intervention in patients with congenital cardiac disease. Methods: We calculated the cross-sectional areas of the arterial roots at the basal attachment of the valvar leaflets, the sinuses, and standardized distal sites using cineangiograms of 59 normal children and adolescents with mean age of 5.4 plus or minus 4.7 years and a range from 0.1 to 16 years, the children having a mean weight of 21.2 plus or minus 15.7 kilograms, with a range from 2.2 to 68 kilograms, and mean height of 108 plus or minus 35 centimetres, with a range from 43 to 184 centimetres. Values at each site were calculated averaging end-diastolic and end-systolic measurements, and indexed to body surface area. Results are expressed as the mean plus or minus the standard deviation. Results: The diameter of the aortic root at the basal attachment of the leaflets was 249 plus or minus 26, the midpoint of the sinuses 379 plus or minus 59, the sinutubular junction 290 plus or minus 58, the isthmus 158 plus or minus 36, the postisthmic region 152 plus or minus 33, and the descending aorta at the level of diaphragm 130 plus or minus 18 millimetres squared per metre squared. The pulmonary root measured at the basal attachment of the leaflets was 253 plus or minus 28, the midpoint of the sinuses 352 plus or minus 58, the sinutubular junction 293 plus or minus 58, the right pulmonary artery 176 plus or minus 25, the left pulmonary artery 153 plus or minus 20, and sum of right and left pulmonary arteries 330 plus or minus 37 millimetres squared per metre squared. All indexes were consistent over a wide range for body surface areas. Conclusions: Definition of normative data of the great vessels may aid in the evaluation of congenital or acquired abnormalities, serving as guidelines for intervention during medical or surgical management and follow-up.

Type
Original Article
Copyright
© 2005 Cambridge University Press

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References

Moss AJ, Adams FH, O'Loughlin BJ, Dixon WJ. The growth of the normal aorta and of the anastomotic site in infants following surgical resection of coarctation of the aorta. Circulation 1959; 19: 338349.Google Scholar
Blackstone EH, Kirklin JW, Bertranou EG, Labrosse CJ, Soto B, Bargeron LM Jr. Preoperative prediction from cineangiograms of postrepair right ventricular pressure in tetralogy of Fallot. J Thorac Cardiovasc Surg 1979; 78: 542552.Google Scholar
Girod DA, Rice MJ, Mair DD, Julsrud PR, Puga FJ, Danielson GK. Relationship of pulmonary artery size to mortality in patients undergoing the Fontan operation. Circulation 1985; 72: II93II96.Google Scholar
Rammos S, Kramer HH, Trampisch HJ, Kozlik R, Krogmann ON, Bourgeois M. Normal values of the growth of the aorta in children. An angiography study. Herz 1989; 14: 358366.Google Scholar
Clarkson PM, Brandt PW. Aortic diameters in infants and young children: normative angiographic data. Pediatr Cardiol 1985; 6: 36.Google Scholar
Hernandez FA, Castellanos A. The size of the main pulmonary artery in congenital heart disease. Angiocardiographic measurement. Acta Cardiol 1966; 21: 119.Google Scholar
Jarmakani JM, Graham TP Jr, Benson DW Jr, Canent RV Jr, Greenfield JC Jr. In vivo pressure-radius relationships of the pulmonary artery in children with congenital heart disease. Circulation 1971; 43: 585592.Google Scholar
Rammos S, Kramer HH, Trampisch HJ, Krogmann ON, Kozlik R, Bourgeois M. Normal values of the growth of the pulmonary arteries in children. An angiography study. Herz 1989; 14: 348357.Google Scholar
Sievers HH, Onnasch DG, Lange PE, Bernhard A, Heintzen PH. Dimensions of the great arteries, semilunar valve roots, and right ventricular outflow tract during growth: normative angiocardiographic data. Pediatr Cardiol 1983; 4: 189196.Google Scholar
Epstein ML, Goldberg SJ, Allen HD, Konecke L, Wood J. Great vessel, cardiac chamber, and wall growth patterns in normal children. Circulation 1975; 51: 11241129.Google Scholar
Snider AR, Enderlein MA, Teitel DF, Juster RP. Two-dimensional echocardiographic determination of aortic and pulmonary artery sizes from infancy to adulthood in normal subjects. Am J Cardiol 1984; 53: 218224.Google Scholar
Castellanos A, Hernandez FA, Mercado H. Angiocardiographic measurement of the right main pulmonary artery in congenital heart disease. Angiology 1966; 17: 743755.Google Scholar
Nakata S, Imai Y, Takanashi Y, et al. A new method for the quantitative standardization of cross-sectional areas of the pulmonary arteries in congenital heart diseases with decreased pulmonary blood flow. J Thorac Cardiovasc Surg 1984; 88: 610619.Google Scholar
Anderson RH. Clinical anatomy of the aortic root. Heart 2000; 84: 670673.Google Scholar
Stamm C, Anderson RH, Ho SY. Clinical anatomy of the normal pulmonary root compared with that in isolated pulmonary valvular stenosis. J Am Coll Cardiol 1998; 31: 14201425.Google Scholar
McGoon DC, Baird DK, Davis GD. Surgical management of large bronchial collateral arteries with pulmonary stenosis or atresia. Circulation 1975; 52: 109118.Google Scholar
Fontan F, Fernandez G, Costa F, et al. The size of the pulmonary arteries and the results of the Fontan operation. J Thorac Cardiovasc Surg 1989; 98: 711719; discussion 719–724.Google Scholar