Abstract 11415: Longitudinal Patterns of Aortic Root Growth in Repaired Tetralogy of Fallot Patients Show Progressive Dilation
Introduction: Aortic root dilation is found in tetralogy of Fallot (TOF) patients. It is unclear if the dilation exists prior to repair and persists or if it is progressive. We sought to define the pattern of growth over long term follow-up and to identify risk factors for aortic root dilation.
Methods: Serial echocardiograms of 144 patients with repaired TOF were retrospectively reviewed. Patient data regarding diagnosis, type of and age at repair, and history of aorto-pulmonary shunt were recorded. Measurements of the aorta were made at the annulus, sinuses, sinotubular junction (STJ) and ascending aorta (AA) and converted to z-scores based on body surface area.
Results: Patients were divided into two cohorts with 101 patients who had surgical repair prior to 2000 (cohort 1) and 43 patients who had surgery from 2000 to present (cohort 2). In both cohorts the aortic annulus z-scores showed a significant increase over time, but had a decrease in rate of growth over time. In cohort 1 the sinus and STJ z-scores decreased in childhood, then increased. There was no change over time in AA z-scores in either cohort or in the STJ z-scores in cohort 2. The patterns of change over time were the same in patients with final z-scores greater than two and less than two. Multivariate analysis found that repair after one year of age and history of shunt were independently associated with higher z-scores of the sinuses, STJ and AA in cohort 1.
Conclusions: Progressive increase in aortic root z-scores occurs in repaired TOF patients, particularly at the annulus and sinus, and is not limited to patients with z-scores over two. Repair after one year of age and history of shunt were predictors of higher z-scores.
- © 2010 by American Heart Association, Inc.