Aortic dissection in a Chinese patient 31 years after surgical repair of tetralogy of Fallot

“…Saiki et al reported a marked reduction in the wall elasticity of AAo in patients with rTOF [18]. Moreover, all previous case reports of aortic dissection showed AAo diameters of >55 mm with AAo being larger than SoV, and the described intimal tear being found in AAo [5,[19][20][21][22][23]. These outcomes reflect the importance of complete aortic screening, including not only the aortic root but also the proximal aorta.…”

Section: Aortic Dilatation: Definition Prevalence and Level Of Measurementmentioning

confidence: 92%

Proximal Aortic Dilatation and Pulmonary Valve Replacement in Patients with Repaired Tetralogy of Fallot: Is There a Relationship? A Cardiac Magnetic Resonance Imaging Study

Mohammed

Frick

Kerst

et al. 2021

JCM

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Aortopathy is a known complication whose incidence is growing within the population of tetralogy of Fallot (TOF) patients. Its pathology and relationship with other comorbidities remain unclear. This study was designed to determine the prevalence and predictors of proximal aortic dilatation after TOF repair. We retrospectively investigated all patients who underwent follow-up cardiac magnetic resonance imaging (CMR; at least 4 years after TOF repair) between March 2004 and December 2019. The dimensions at the ascending aorta (AAo) and sinus of Valsalva (SoV) levels were measured. Aortic dilatation was defined as an internal aortic diameter that was >2 standard deviation of the previously published normal values. We included 77 patients (mean age 28.9 ± 10.5 years, 41.5% female, mean follow-up of 24.5 ± 8.1 years). AAo and SoV were dilated in 19 (24.6%) and 43 (55.8%) patients, respectively. Patients with dilated AAo and SoV were older during the corrective surgery (p < 0.001 and p = 0.004, respectively) and during CMR (p = 0.002 and 0.024, respectively) than patients without AAo and SoV dilatation. Patients of the dilated AAo group were more likely to have prior palliative shunt (p = 0.008), longer shunt duration (p = 0.005), and a higher degree of aortic valve regurgitation (AR) fraction (p < 0.001) and to undergo pulmonary (PVR) and/or aortic valve replacement (p < 0.001 and p = 0.013, respectively). PVR (p = 0.048, odds ratio = 6.413, and 95% CI = 1.013–40.619) and higher AR fraction (p = 0.031, odds ratio = 1.194, and 95% CI = 1.017–1.403) were independent predictors for AAo dilatation. Aortopathy is a common progressive complication that may require reintervention and lifelong follow-up. Our study shows that proximal aortic dilatation may be attributed to factors that increase the volume overload across the proximal aorta, including late corrective surgery and palliative shunt. We also found that PVR and higher AR fraction are independent predictors of AAo dilatation.

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“…This case report describes the imaging examination, especially echocardiogram and computed tomography (CT) scans, in a patient who had an acute and severe aortic dissection, with an important hypotensive shock (Kim et al, 2011;Chow et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

A Severe and Fatal Type A Aortic Dissection in an Adult with a Repaired Tetralogy of Fallot

Montatore,

Masino,

Signorile

et al. 2024

Prague Med. Rep.

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We report a case of a 44-year-old woman surgically treated for tetralogy of Fallot who experienced an acute and extensive Stanford A type aortic dissection despite the meticulous follow-up. While aortic dilatation is prevalent in individuals with repaired tetralogy of Fallot, aortic dissection represents a rare consequence, that when it appears, is progressive and usually detected during the check-up visits. In the case reported, the dissection was unexpected and severe, and the patient’s clinical state worsened suddenly, leading to death after a few days. Constant awareness for aortic aneurysms is essential in the Fallot tetralogy population, nevertheless, several causes may contribute to the acute worsening of the clinical condition until the patient’s death.

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Aortic dissection in a Chinese patient 31 years after surgical repair of tetralogy of Fallot

Cited by 7 publications

References 11 publications

Tetralogy of Fallot and Aortic Dissection

Tetralogy of Fallot and Aortic Dissection

Proximal Aortic Dilatation and Pulmonary Valve Replacement in Patients with Repaired Tetralogy of Fallot: Is There a Relationship? A Cardiac Magnetic Resonance Imaging Study

A Severe and Fatal Type A Aortic Dissection in an Adult with a Repaired Tetralogy of Fallot

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