Abstract 14545: Aortic Root and Main Pulmonary Artery Areas Derived from Cardiovascular Magnetic Resonance as Reference Values for Normal Subjects and Repaired Tetralogy of Fallot
Background Cardiac magnetic resonance imaging (CMR) is an important clinical tool for serial follow-up of patients with congenital heart disease, but normative data for great vessel dimensions in pediatric subjects are scarce. We investigated aortic root (Ao) and main pulmonary artery (MPA) areas in normal children and young adults in comparison with a cohort of repaired tetralogy of Fallot (TOF) patients.
Methods: Subjects were prospectively enrolled for CMR following a standardized protocol in 14 participating centers of the German Competence Network for Congenital Heart Defects. All studies were performed in 1.5 T scanners and utilized single-slice multi-phase acquisitions-steady state free precession and velocity encoded cine. Aortic root and main pulmonary artery areas were measured.
Results: The cohort consisted of 483 subjects: 105 normal controls (55 male, 50 female, median age, 13 years) and 378 patients with repaired TOF (210 male, 168 female, median age 16 years). Among TOF, 35 (9%) had pulmonary atresia, 98 (26%) had a palliative procedure before repair, the mean age at repair was 2.5 years, and 78 (21%) utilized a transannular patch repair. Great vessel areas correlated well with body surface area and age in controls and reference Z-score values were derived. Z-scores for Ao root areas were larger in TOF (Figure) compared to controls (mean Z-score 1.95, p=0.001). In TOF, pulmonary atresia (p=0.003), male gender (p=0.01) and previous palliations (p=0.003) were associated with larger Ao areas. MPA area Z-scores in TOF did not show significant difference from controls (p=0.10).
Conclusions: This study provides CMR reference Z-scores for great vessel dimensions in normal children and adolescents in comparison with a large cohort of repaired TOF. Male gender, pulmonary atresia and previous palliations emerged as predictors for larger Ao area Z-scores in TOF.
- © 2011 by American Heart Association, Inc.