Evaluating the severity of aortic coarctation in infants using anatomic features measured on CTA

Yu, Yiming; Wang, Yübo; Mao-qing, Yang; Huang, Meiping; Li, Jun; Jia, Quanli; Zhuang, Jian; Huang, Luqi

doi:10.1007/s00330-020-07238-1

Cited by 6 publications

(8 citation statements)

References 28 publications

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“…These 2D/3D images show multi-plane, multi-angle intuitive stereoscopic imaging of CoA and provide accurate measurement of the length and degree of CoA. The collateral circulation and other malformations, as well as the position relationship between blood vessels and between blood vessels and soft tissues could be seen clearly ( 18 , 19 ). Echocardiography and CTA complement each other to provide a strong reference for clarifying the diagnosis, location, and extent of CoA, and are more commonly used in children.…”

Section: Discussionmentioning

confidence: 97%

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Using computed tomography angiography and computational fluid dynamics to study aortic coarctation in different arch morphologies

et al. 2023

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ObjectiveTo study the differences in computed tomography angiography (CTA) imaging of gothic arches, crenel arches, and romanesque arches in children with Aortic Coarctation (CoA), and to apply computational fluid dynamics (CFD) to study hemodynamic changes in CoA children with gothic arch aorta.MethodsThe case data and CTA data of children diagnosed with CoA (95 cases) in our hospital were retrospectively collected, and the morphology of the aortic arch in the children was defined as gothic arch (n = 27), crenel arch (n = 25) and romanesque arch (n = 43). The three groups were compared with D1/AOA, D2/AOA, D3/AOA, D4/AOA, D5/AOA, and AAO-DAO angle, TAO-DAO angle, and aortic arch height to width ratio (A/T). Computational fluid dynamics was applied to assess hemodynamic changes in children with gothic arches.ResultsThere were no significant differences between D1/AOA and D2/AOA among gothic arch, crenel arch, and romanesque arch (P > 0.05). The differences in D3/AOA, D4/AOA, and D5/AOA among the three groups were statistically significant (P < 0.05), D4/AOA, D5/AOA of the gothic arch group were smaller than the crenel arch group, and the D3/AOA and D5/AOA of the gothic arch group were smaller than the romanesque arch group (P < 0.05). The difference in AAO-DAO angle among the three groups was statistically significant (P < 0.05), and the AAO-DAO angle of gothic arch was smaller than that of romanesque arch and crenel arch group (P < 0.05). There was no significant difference in the TAO-DAO angle between the three groups (P > 0.05). The difference in A/T values among the three groups was statistically significant (P < 0.05), and the A/T values: gothic arch > romanesque arch > crenel arch (P < 0.05). The CFD calculation of children with gothic arch showed that the pressure drop between the distal stenosis and the descending aorta was 58 mmHg, and the flow rate at the isthmus and descending aorta was high and turbulent.ConclusionGothic aortic arch is common in CoA, it may put adverse effects on the development of the aortic isthmus and descending aorta, and its A/T value and AAO-DAO angle are high. CFD could assess hemodynamic changes in CoA.

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Section: Discussionmentioning

confidence: 97%

“…In addition, PSPG was correlated with the degree of stenosis ( 18 ). In this study, the 95 cases were grouped according to arch morphology, and there was no significant statistical difference in PSPG between the groups as measured by echocardiography.…”

Section: Discussionmentioning

confidence: 99%

Using computed tomography angiography and computational fluid dynamics to study aortic coarctation in different arch morphologies

et al. 2023

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“…The aorta measurement was performed along the vertical direction of the long axis of the aorta in the median sagittal plane of the aortic arch. The ratio of the aortic diameter at the coarctation site to that at the diaphragm (coarctation site-diaphragm ratio, CDR) was calculated to describe the degree of coarctation as follows: CDR < 75%, diagnosed as aortic coarctation; 50% < CDR > 75%, diagnosed as mild coarctation; and CDR < 50%, diagnosed as severe coarctation ( 22 , 23 ). To account for growth-related changes, the aortic diameter was normalized to a Z score, which was the ratio of aortic diameter to the square root of body surface area.…”

Section: Methodsmentioning

confidence: 99%

Evaluation of the aorta in infants with simple or complex coarctation of the aorta using CT angiography

Xiao

Zhan

Huang

et al. 2023

Front. Cardiovasc. Med.

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ObjectiveTo assess aortic dilatation and determine its related factors in infants with coarctation of the aorta (CoA) by using computed tomography angiography (CTA).MethodsThe clinical data of 55 infantile patients with CoA diagnosed by CTA were analyzed retrospectively. Aortic diameters were measured at six different levels and standardized as Z scores based on the square root of body surface area. The results of simple and complex CoA were compared. Univariate and multivariate logistic regression were used to analyze the effects of sex, age, hypertension, degree of coarctation, CoA type, bicuspid aortic valve (BAV), and other factors related to aortic dilatation.ResultsIn total, 52 infant patients with CoA were analyzed, including 22 cases of simple CoA and 30 cases of complex CoA. The ascending aorta of the infants in the simple CoA group and the complex CoA group were dilated to different degrees, but the difference was not statistically significant (50.00% vs. 73.33%, P = 0.084, and 2.05 ± 0.40 vs. 2.22 ± 0.43 P = 0.143). The infants in the complex CoA group had more aortic arch hypoplasia than those in the simple CoA group (33.33% vs. 9.09%, P = 0.042). Compared to the ventricular septal defect (VSD) group, the Z score of the ascending aorta in the CoA group was significantly higher than that in the VSD group (P = 0.023 and P = 0.000). A logistic retrospective analysis found that an increased degree of coarctation (CDR value) was an independent predictor of ascending aortic dilatation (adjusted OR = 0.002; P = 0.034).ConclusionInfants with simple or complex CoA are at risk of ascending aortic dilatation, and the factors of ascending aortic dilatation depend on the degree of coarctation. The risk of aortic dilatation in infants with CoA can be identified by CTA.

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“…Therefore, for efficient therapy planning, knowledge of the degree of aortic coarctation is essential [5,7] . It was recently demonstrated that the pressure gradient brought on by coarctation corresponds to changes in the aorta's anatomical structure, Anatomical variables by themselves, however, might be misleading, Therefore, a trustworthy evaluation of the degree of coarctation might be accomplished by combining both physical characteristics and demographic data representing body development (such as height, age, and weight) [8,9] . The aim of this work was to quantify the extent of the aortic coarctation by using the anatomical features measured on 320 slice multi-detector computed tomography angiography.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic efficiency of anatomic features measured by 320- slice multi-detector computed tomography angiography in evaluating the severity of aortic coarctation

Abdelmaksoud,

Mohamad,

Dawoud

et al. 2023

Int. J. Radiol. Diagn. Imaging

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Background: Coarctation of the aorta is the most frequent congenital anomaly of the thoracic aorta. It's severity depend on pressure gradient across coarctation site that has been shown to be correlated with antomical structure alternation in the aorta. The aim of this work was to quantify the extent of coarctation of the aorta by utilizing the anatomical characteristics determined on 320 slice multidetector computed tomography angiography. Methods: This prospective work was performed on 50 individuals (29 males and 21 females) aged from 1 day to 29 years old, with clinical criteria of patients known and suspected aortic coarctation or presented with other cardiac anomalies by echocardiography. By computed tomography the diameter of aorta at coarctation site and at diaphragm were measured, four ratios were calculated; coarctation area / body surface area ratio, diameter of aortic coarctation / diameter of descending aorta ratio, coarctation diameter / height ratio and coarctation diameter / weight ratio. Results: By statistical correlation, multi-slice CT could classify the severity of aortic coarctation by indexing aortic coarctation area to patient body surface area with sensitivity 95.65%, specificity 92.86% and cut off value ≤23.8 mm 2 . Conclusions: The anatomical characteristics derived from computed tomography angiography can assess the extent of aortic coarctation, suggesting that it is important to take into account both the anatomical alterations at the CoA sites and the patient's development.

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Evaluating the severity of aortic coarctation in infants using anatomic features measured on CTA

Cited by 6 publications

References 28 publications

Using computed tomography angiography and computational fluid dynamics to study aortic coarctation in different arch morphologies

Using computed tomography angiography and computational fluid dynamics to study aortic coarctation in different arch morphologies

Evaluation of the aorta in infants with simple or complex coarctation of the aorta using CT angiography

Diagnostic efficiency of anatomic features measured by 320- slice multi-detector computed tomography angiography in evaluating the severity of aortic coarctation

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