Magnetic resonance imaging assessment of aortic dilatation and distensibility in 269 patients with repaired tetralogy of Fallot

Purpose To determine the prevalence and degree of aortic dilatation (A(dilatation)), severity of aortic stiffness (A(stiff)), factors for A(dilatation,) and level of aortic root most sensitive to A(stiff) in patients with repaired tetralogy of Fallot (rTOF). Materials and methods 269 patients with rTOF (mean age 14.9 +/- standard deviation 5.0 years) were analyzed for A(dilatation) at annulus, sinus, sinotubular junction, and ascending aorta (aAo). Aortic size index was graded as Z score < 2, 2-2.99, 3-4.99 and >= 5. Aortic distensibility (aA(dis)) was categorized according to 4 aortic levels and dilatation severity. Factors for A(dilatation) and level of aortic root most sensitive to A(stiff) were analyzed. Results Sinus and aAo were the two most common sites of A(dilatation), with a prevalence of 84% and 76%, respectively. A decreased aA(dis) was found (mean 5.38 +/- 1.79 10(-3) mmHg(-1)). aA(dis) only declined significantly at the sinus level (p = 0.009). Male sex, age-at-repair and aortic regurgitation were significant factors for A(dilatation), with male sex as the strongest factor (odds ratio 2.94). There was a significant decline in aA(dis) at sinus level (p = 0.002) as A(dilatation) progressed. Conclusions We observed a high prevalence of A(dilatation) and A(stiff) in patients with rTOF. Male sex is the strongest factor for A(dilatation). The sinus is the most sensitive area for determining a negative aA(dis) effect.

Automated summary

The study found a high prevalence of aortic dilatation and stiffness in patients with repaired tetralogy of Fallot, with males being more susceptible to aortic dilatation. The aortic sinus is the most sensitive area for determining the negative effect of aortic distensibility.