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. 2023 Jul 24:10:1078038.
doi: 10.3389/fcvm.2023.1078038. eCollection 2023.

Diagnosis and surgical outcomes of coarctation of the aorta in pediatric patients: a retrospective study

Ting Gong #  1   2 , Feiyan Zhang #  2   3 , Lingxin Feng  2 , Xu Zhu  2 , Dan Deng  4 , Tingting Ran  2 , Liling Li  2 , Li Kong  2 , Liqun Sun  5 , Xiaojuan Ji  2   6
Affiliations

Diagnosis and surgical outcomes of coarctation of the aorta in pediatric patients: a retrospective study

Ting Gong et al. Front Cardiovasc Med. .

Abstract

Background: Coarctation of the aorta (CoA) is a common congenital cardiovascular malformation, and improvements in the diagnostic process for surgical decision-making are important. We sought to compare the diagnostic accuracy of transthoracic echocardiography (TTE) with computed tomographic angiography (CTA) to diagnose CoA.

Methods: We retrospectively reviewed 197 cases of CoA diagnosed by TTE and CTA and confirmed at surgery from July 2009 to August 2019.

Results: The surgical findings confirmed that 19 patients (9.6%) had isolated CoA and 178 (90.4%) had CoA combined with other congenital cardiovascular malformations. The diagnostic accuracy of CoA by CTA was significantly higher than that of TTE (χ2 = 6.52, p = 0.01). In contrast, the diagnostic accuracy of TTE for associated cardiovascular malformations of CoA was significantly higher than that of CTA (χ2 = 15.36, p < 0.0001). Infants and young children had more preductal type of CoA, and PDA was the most frequent cardiovascular lesion associated with CoA. The pressure gradient was significantly decreased after the first operation, similar at 6 months, 1 year, and 3 years follow-ups by TTE.

Conclusions: CTA is more accurate as a clinical tool for diagnosing CoA; however, TTE with color Doppler can better identify associated congenital cardiovascular malformations. Therefore, combining TTE and CTA would benefit clinical evaluation and management in patients suspected of CoA. TTE was valuable for post-operation follow-up and clinical management.

Keywords: coarctation of the aorta; computed tomographic angiography; congenital heart disease; surgical outcome; transthoracic echocardiography.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
A flowchart of this retrospective cohort.
Figure 2
Figure 2
TTE with color Doppler flow imaging showed the location of the CoA and increased blood flow velocity: (A) indicate the location of the CoA and multicolored flow signal; and (B) increased blood flow velocity with a high-pressure gradient, which was estimated by a continuous-wave Doppler. (C) Left ventricular hypertrophy.
Figure 3
Figure 3
Ductal CoA by CTA. (A) The anatomical measurements by CTA before cardiac surgery; (B,C) sagittal multiplanar reconstruction showed volume rendering images with CoA.
Figure 4
Figure 4
The comparison of the pressure gradient between pre-operation and post-operation before discharge, 6 months, 1 year, and 3 years by TTE.
See this image and copyright information in PMC

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References

    1. Gach P, Dabadie A, Sorensen C, Quarello E, Bonello B, Pico H, et al. Multimodality imaging of aortic coarctation: from the fetus to the adolescent. Diagn Interv Imaging. (2016) 97(5):581–90. 10.1016/j.diii.2016.03.006 - DOI - PubMed
    1. Pádua LMS, Garcia LC, Rubira CJ, de Oliveira Carvalho PE. Stent placement versus surgery for coarctation of the thoracic aorta. Cochrane Database Syst Rev. (2012) 16(5):CD008204. 10.1002/14651858.cd008204.pub2 - DOI - PMC - PubMed
    1. Hoffman JIE, Kaplan S. The incidence of congenital heart disease. J Am Coll Cardiol. (2002) 39(12):1890–900. 10.1016/S0735-1097(02)01886-7 - DOI - PubMed
    1. Budoff MJ, Shittu A, Roy S. Use of cardiovascular computed tomography in the diagnosis and management of coarctation of the aorta. J Thorac Cardiovasc Surg. (2013) 146(1):229–32. 10.1016/j.jtcvs.2013.01.024 - DOI - PubMed
    1. Singh S, Hakim FA, Sharma A, Roy RR, Panse PM, Chandrasekaran K, et al. Hypoplasia, pseudocoarctation and coarctation of the aorta—a systematic review. Heart Lung Circ. (2015) 24(2):110–8. 10.1016/j.hlc.2014.08.006 - DOI - PubMed

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