The Cardiothoracic Surgeon (Nov 2023)
Assessment of anatomy of the aorta in patients with a coarctation of aorta
Abstract
Abstract Background Coarctation of the aorta (CoA) is a congenital heart disease characterized by the narrowing of the aorta, resulting in reduced blood flow to the body and increased pressure in the left ventricle. The pathophysiology of CoA is complex and involves several changes in the structure and function of the aorta. Recent studies have suggested that patients with CoA may have changes in the aortic wall beyond the site of the narrowing. Understanding these changes in the aorta is essential for optimizing the management of patients with CoA. Methods Eighty-five patients who were diagnosed with an isolated coarctation of aorta (CoA) and underwent elective surgical repair—during the last 10 years were included in the study. Results Eighty-five patients (62 males, 72.9%) with a median age of 7 years old (range from 1 month to 48 years old) underwent surgical repair of CoA during the last 10 years using 4 different methods of operation. The study showed that more than a half (51.7%) of our patients with coarctation of the aorta had an enlargement of an ascending aorta, and z-score of ascending aortic size positively correlated with age, height, and weight, which means in patients with non-corrected CoA, ascending aorta tends to enlarge by time. In the present study, 31.8% of patients had an aortic arch hypoplasia, and aortic arch sizes z-score negatively correlated with ICU and hospital stay, which indicates that, patients with smaller aortic arch have poorer outcomes. Therefore, evaluating AAH before planning surgical repair is important for achieving better results. CT examination showed advantages in assessing aortic anatomy. Conclusions It is suggested that an MSCT examination should be performed to take into consideration of current aortic anatomy, before planning the surgical correction of the aortic coarctation to achieve better results.
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