Aortic Root Dilatation in Adults with Surgically Repaired Tetralogy of Fallot: A Multicenter Cross-Sectional Study
Identifieur interne : 000474 ( Canada/Analysis ); précédent : 000473; suivant : 000475Aortic Root Dilatation in Adults with Surgically Repaired Tetralogy of Fallot: A Multicenter Cross-Sectional Study
Auteurs : François-Pierre Mongeon [Canada] ; Michelle Z. Gurvitz [États-Unis] ; Craig S. Broberg [États-Unis] ; Jamil Aboulhosn [États-Unis] ; Alexander R. Opotowsky [États-Unis] ; Joseph D. Kay [États-Unis] ; Anne Marie Valente [États-Unis] ; Michael G. Earing [États-Unis] ; George K. Lui [États-Unis] ; Susan M. Fernandes [États-Unis] ; Deborah R. Gersony [États-Unis] ; Stephen C. Cook [États-Unis] ; Jennifer Grando Ting [États-Unis] ; Michelle J. Nickolaus [États-Unis] ; Michael J. Landzberg [États-Unis] ; Paul Khairy [Canada, États-Unis]Source :
- Circulation : (New York, N.Y.) [ 0009-7322 ] ; 2013.
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Abstract
Background-Although aortic root pathology has been described in patients with tetralogy of Fallot, the scope of the problem remains poorly defined. We sought to determine the prevalence and predictors of aortic root dilatation in adults with repaired tetralogy of Fallot. Methods and Results-A multicenter cross-sectional study was conducted with standardized reassessment of echocardiographic parameters in 474 adults (≥18 years) with surgically repaired tetralogy of Fallot or pulmonary atresia with ventricular septal defect. The aortic root was measured in a parasternal long-axis view, in diastole, at the level of the sinus of Valsalva. Prevalence and predictors of an absolute diameter ≥40 mm and of an observed-to-expected ratio >1.5 were assessed. The aortic root dimension was ≥40 mm in 28.9% (95% confidence interval, 26.9%-30.9%). In multivariate analyses, the only independently associated factor was male sex (odds ratio, 4.48; 95% confidence interval, 1.55-12.89; P=0.006). The prevalence of an observed-to-expected aortic root dimension ratio >1.5 was 6.6% (95% confidence interval, 5.3%-7.9%). It was associated with pulmonary atresia and moderate or severe aortic regurgitation in univariate analyses, but no independent predictor was identified. The side of the aortic arch was not associated with aortic root dimension. The prevalence of moderate or severe aortic regurgitation was 3.5% (95% confidence interval, 2.7%-4.2%). Conclusions-Although nearly one third of adults with repaired tetralogy of Fallot have an aortic root diameter ≥40 mm, the prevalence of a dilated aortic root, when defined by an indexed ratio of observed-to-expected values, is low. Similarly, moderate or severe aortic regurgitation is uncommon.
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en" level="a">Aortic Root Dilatation in Adults with Surgically Repaired Tetralogy of Fallot: A Multicenter Cross-Sectional Study</title><author><name sortKey="Mongeon, Francois Pierre" sort="Mongeon, Francois Pierre" uniqKey="Mongeon F" first="François-Pierre" last="Mongeon">François-Pierre Mongeon</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Adult Congenital Heart Center, Montreal Heart Institute, Universite de Montreal</s1><s2>Montreal, Quebec</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>16 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Montreal, Quebec</wicri:noRegion></affiliation></author><author><name sortKey="Gurvitz, Michelle Z" sort="Gurvitz, Michelle Z" uniqKey="Gurvitz M" first="Michelle Z." last="Gurvitz">Michelle Z. Gurvitz</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Boston Adult Congenital Heart Service, Children's Hospital Boston and Brigham and Women's Hospital</s1><s2>Boston, MA</s2><s3>USA</s3><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ><sZ>15 aut.</sZ><sZ>16 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Boston, MA</wicri:noRegion></affiliation></author><author><name sortKey="Broberg, Craig S" sort="Broberg, Craig S" uniqKey="Broberg C" first="Craig S." last="Broberg">Craig S. Broberg</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Oregon Health and Science University</s1><s2>Portland, OR</s2><s3>USA</s3><sZ>3 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Oregon Health and Science University</wicri:noRegion></affiliation></author><author><name sortKey="Aboulhosn, Jamil" sort="Aboulhosn, Jamil" uniqKey="Aboulhosn J" first="Jamil" last="Aboulhosn">Jamil Aboulhosn</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Ahmanson/UCLA Adult Congenital Heart Disease Center</s1><s2>Los Angeles, CA</s2><s3>USA</s3><sZ>4 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Ahmanson/UCLA Adult Congenital Heart Disease Center</wicri:noRegion></affiliation></author><author><name sortKey="Opotowsky, Alexander R" sort="Opotowsky, Alexander R" uniqKey="Opotowsky A" first="Alexander R." last="Opotowsky">Alexander R. Opotowsky</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Boston Adult Congenital Heart Service, Children's Hospital Boston and Brigham and Women's Hospital</s1><s2>Boston, MA</s2><s3>USA</s3><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ><sZ>15 aut.</sZ><sZ>16 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Boston, MA</wicri:noRegion></affiliation></author><author><name sortKey="Kay, Joseph D" sort="Kay, Joseph D" uniqKey="Kay J" first="Joseph D." last="Kay">Joseph D. Kay</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>University of Colorado</s1><s2>Denver, CO</s2><s3>USA</s3><sZ>6 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>University of Colorado</wicri:noRegion></affiliation></author><author><name sortKey="Valente, Anne Marie" sort="Valente, Anne Marie" uniqKey="Valente A" first="Anne Marie" last="Valente">Anne Marie Valente</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Boston Adult Congenital Heart Service, Children's Hospital Boston and Brigham and Women's Hospital</s1><s2>Boston, MA</s2><s3>USA</s3><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ><sZ>15 aut.</sZ><sZ>16 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Boston, MA</wicri:noRegion></affiliation></author><author><name sortKey="Earing, Michael G" sort="Earing, Michael G" uniqKey="Earing M" first="Michael G." last="Earing">Michael G. Earing</name><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>Medical College of Wisconsin</s1><s2>Milwaukee, WI</s2><s3>USA</s3><sZ>8 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Medical College of Wisconsin</wicri:noRegion></affiliation></author><author><name sortKey="Lui, George K" sort="Lui, George K" uniqKey="Lui G" first="George K." last="Lui">George K. Lui</name><affiliation wicri:level="1"><inist:fA14 i1="07"><s1>Montefiore Medical Center, Albert Einstein College of Medicine</s1><s2>Bronx, NY</s2><s3>USA</s3><sZ>9 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Bronx, NY</wicri:noRegion></affiliation></author><author><name sortKey="Fernandes, Susan M" sort="Fernandes, Susan M" uniqKey="Fernandes S" first="Susan M." last="Fernandes">Susan M. Fernandes</name><affiliation wicri:level="1"><inist:fA14 i1="08"><s1>Stanford Adult Congenital Heart Program, Lucile Packard Children's Hospital</s1><s2>Palo Alto, CA</s2><s3>USA</s3><sZ>10 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Palo Alto, CA</wicri:noRegion></affiliation></author><author><name sortKey="Gersony, Deborah R" sort="Gersony, Deborah R" uniqKey="Gersony D" first="Deborah R." last="Gersony">Deborah R. Gersony</name><affiliation wicri:level="1"><inist:fA14 i1="09"><s1>Columbia University Medical Center</s1><s2>New York, NY</s2><s3>USA</s3><sZ>11 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Columbia University Medical Center</wicri:noRegion></affiliation></author><author><name sortKey="Cook, Stephen C" sort="Cook, Stephen C" uniqKey="Cook S" first="Stephen C." last="Cook">Stephen C. Cook</name><affiliation wicri:level="1"><inist:fA14 i1="10"><s1>University of Pittsburgh Medical Center</s1><s2>Pittsburgh, PA</s2><s3>USA</s3><sZ>12 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>University of Pittsburgh Medical Center</wicri:noRegion></affiliation></author><author><name sortKey="Grando Ting, Jennifer" sort="Grando Ting, Jennifer" uniqKey="Grando Ting J" first="Jennifer" last="Grando Ting">Jennifer Grando Ting</name><affiliation wicri:level="4"><inist:fA14 i1="11"><s1>Hershey Medical Center, Pennsylvania State University</s1><s2>Hershey, PA</s2><s3>USA</s3><sZ>13 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><settlement type="city">University Park (Pennsylvanie)</settlement><region type="state">Pennsylvanie</region></placeName><orgName type="university">Université d'État de Pennsylvanie</orgName></affiliation></author><author><name sortKey="Nickolaus, Michelle J" sort="Nickolaus, Michelle J" uniqKey="Nickolaus M" first="Michelle J." last="Nickolaus">Michelle J. Nickolaus</name><affiliation wicri:level="4"><inist:fA14 i1="11"><s1>Hershey Medical Center, Pennsylvania State University</s1><s2>Hershey, PA</s2><s3>USA</s3><sZ>13 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><settlement type="city">University Park (Pennsylvanie)</settlement><region type="state">Pennsylvanie</region></placeName><orgName type="university">Université d'État de Pennsylvanie</orgName></affiliation></author><author><name sortKey="Landzberg, Michael J" sort="Landzberg, Michael J" uniqKey="Landzberg M" first="Michael J." last="Landzberg">Michael J. Landzberg</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Boston Adult Congenital Heart Service, Children's Hospital Boston and Brigham and Women's Hospital</s1><s2>Boston, MA</s2><s3>USA</s3><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ><sZ>15 aut.</sZ><sZ>16 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Boston, MA</wicri:noRegion></affiliation></author><author><name sortKey="Khairy, Paul" sort="Khairy, Paul" uniqKey="Khairy P" first="Paul" last="Khairy">Paul Khairy</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Adult Congenital Heart Center, Montreal Heart Institute, Universite de Montreal</s1><s2>Montreal, Quebec</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>16 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Montreal, Quebec</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Boston Adult Congenital Heart Service, Children's Hospital Boston and Brigham and Women's Hospital</s1><s2>Boston, MA</s2><s3>USA</s3><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ><sZ>15 aut.</sZ><sZ>16 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Boston, MA</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">13-0118059</idno><date when="2013">2013</date><idno type="stanalyst">PASCAL 13-0118059 INIST</idno><idno type="RBID">Pascal:13-0118059</idno><idno type="wicri:Area/PascalFrancis/Corpus">002586</idno><idno type="wicri:Area/PascalFrancis/Curation">002338</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">002086</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">002086</idno><idno type="wicri:doubleKey">0009-7322:2013:Mongeon F:aortic:root:dilatation</idno><idno type="wicri:Area/Main/Merge">007907</idno><idno type="wicri:Area/Main/Curation">007446</idno><idno type="wicri:Area/Main/Exploration">007446</idno><idno type="wicri:Area/Canada/Extraction">000474</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Aortic Root Dilatation in Adults with Surgically Repaired Tetralogy of Fallot: A Multicenter Cross-Sectional Study</title><author><name sortKey="Mongeon, Francois Pierre" sort="Mongeon, Francois Pierre" uniqKey="Mongeon F" first="François-Pierre" last="Mongeon">François-Pierre Mongeon</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Adult Congenital Heart Center, Montreal Heart Institute, Universite de Montreal</s1><s2>Montreal, Quebec</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>16 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Montreal, Quebec</wicri:noRegion></affiliation></author><author><name sortKey="Gurvitz, Michelle Z" sort="Gurvitz, Michelle Z" uniqKey="Gurvitz M" first="Michelle Z." last="Gurvitz">Michelle Z. Gurvitz</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Boston Adult Congenital Heart Service, Children's Hospital Boston and Brigham and Women's Hospital</s1><s2>Boston, MA</s2><s3>USA</s3><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ><sZ>15 aut.</sZ><sZ>16 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Boston, MA</wicri:noRegion></affiliation></author><author><name sortKey="Broberg, Craig S" sort="Broberg, Craig S" uniqKey="Broberg C" first="Craig S." last="Broberg">Craig S. Broberg</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Oregon Health and Science University</s1><s2>Portland, OR</s2><s3>USA</s3><sZ>3 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Oregon Health and Science University</wicri:noRegion></affiliation></author><author><name sortKey="Aboulhosn, Jamil" sort="Aboulhosn, Jamil" uniqKey="Aboulhosn J" first="Jamil" last="Aboulhosn">Jamil Aboulhosn</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Ahmanson/UCLA Adult Congenital Heart Disease Center</s1><s2>Los Angeles, CA</s2><s3>USA</s3><sZ>4 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Ahmanson/UCLA Adult Congenital Heart Disease Center</wicri:noRegion></affiliation></author><author><name sortKey="Opotowsky, Alexander R" sort="Opotowsky, Alexander R" uniqKey="Opotowsky A" first="Alexander R." last="Opotowsky">Alexander R. Opotowsky</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Boston Adult Congenital Heart Service, Children's Hospital Boston and Brigham and Women's Hospital</s1><s2>Boston, MA</s2><s3>USA</s3><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ><sZ>15 aut.</sZ><sZ>16 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Boston, MA</wicri:noRegion></affiliation></author><author><name sortKey="Kay, Joseph D" sort="Kay, Joseph D" uniqKey="Kay J" first="Joseph D." last="Kay">Joseph D. Kay</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>University of Colorado</s1><s2>Denver, CO</s2><s3>USA</s3><sZ>6 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>University of Colorado</wicri:noRegion></affiliation></author><author><name sortKey="Valente, Anne Marie" sort="Valente, Anne Marie" uniqKey="Valente A" first="Anne Marie" last="Valente">Anne Marie Valente</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Boston Adult Congenital Heart Service, Children's Hospital Boston and Brigham and Women's Hospital</s1><s2>Boston, MA</s2><s3>USA</s3><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ><sZ>15 aut.</sZ><sZ>16 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Boston, MA</wicri:noRegion></affiliation></author><author><name sortKey="Earing, Michael G" sort="Earing, Michael G" uniqKey="Earing M" first="Michael G." last="Earing">Michael G. Earing</name><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>Medical College of Wisconsin</s1><s2>Milwaukee, WI</s2><s3>USA</s3><sZ>8 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Medical College of Wisconsin</wicri:noRegion></affiliation></author><author><name sortKey="Lui, George K" sort="Lui, George K" uniqKey="Lui G" first="George K." last="Lui">George K. Lui</name><affiliation wicri:level="1"><inist:fA14 i1="07"><s1>Montefiore Medical Center, Albert Einstein College of Medicine</s1><s2>Bronx, NY</s2><s3>USA</s3><sZ>9 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Bronx, NY</wicri:noRegion></affiliation></author><author><name sortKey="Fernandes, Susan M" sort="Fernandes, Susan M" uniqKey="Fernandes S" first="Susan M." last="Fernandes">Susan M. Fernandes</name><affiliation wicri:level="1"><inist:fA14 i1="08"><s1>Stanford Adult Congenital Heart Program, Lucile Packard Children's Hospital</s1><s2>Palo Alto, CA</s2><s3>USA</s3><sZ>10 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Palo Alto, CA</wicri:noRegion></affiliation></author><author><name sortKey="Gersony, Deborah R" sort="Gersony, Deborah R" uniqKey="Gersony D" first="Deborah R." last="Gersony">Deborah R. Gersony</name><affiliation wicri:level="1"><inist:fA14 i1="09"><s1>Columbia University Medical Center</s1><s2>New York, NY</s2><s3>USA</s3><sZ>11 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Columbia University Medical Center</wicri:noRegion></affiliation></author><author><name sortKey="Cook, Stephen C" sort="Cook, Stephen C" uniqKey="Cook S" first="Stephen C." last="Cook">Stephen C. Cook</name><affiliation wicri:level="1"><inist:fA14 i1="10"><s1>University of Pittsburgh Medical Center</s1><s2>Pittsburgh, PA</s2><s3>USA</s3><sZ>12 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>University of Pittsburgh Medical Center</wicri:noRegion></affiliation></author><author><name sortKey="Grando Ting, Jennifer" sort="Grando Ting, Jennifer" uniqKey="Grando Ting J" first="Jennifer" last="Grando Ting">Jennifer Grando Ting</name><affiliation wicri:level="4"><inist:fA14 i1="11"><s1>Hershey Medical Center, Pennsylvania State University</s1><s2>Hershey, PA</s2><s3>USA</s3><sZ>13 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><settlement type="city">University Park (Pennsylvanie)</settlement><region type="state">Pennsylvanie</region></placeName><orgName type="university">Université d'État de Pennsylvanie</orgName></affiliation></author><author><name sortKey="Nickolaus, Michelle J" sort="Nickolaus, Michelle J" uniqKey="Nickolaus M" first="Michelle J." last="Nickolaus">Michelle J. Nickolaus</name><affiliation wicri:level="4"><inist:fA14 i1="11"><s1>Hershey Medical Center, Pennsylvania State University</s1><s2>Hershey, PA</s2><s3>USA</s3><sZ>13 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><settlement type="city">University Park (Pennsylvanie)</settlement><region type="state">Pennsylvanie</region></placeName><orgName type="university">Université d'État de Pennsylvanie</orgName></affiliation></author><author><name sortKey="Landzberg, Michael J" sort="Landzberg, Michael J" uniqKey="Landzberg M" first="Michael J." last="Landzberg">Michael J. Landzberg</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Boston Adult Congenital Heart Service, Children's Hospital Boston and Brigham and Women's Hospital</s1><s2>Boston, MA</s2><s3>USA</s3><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ><sZ>15 aut.</sZ><sZ>16 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Boston, MA</wicri:noRegion></affiliation></author><author><name sortKey="Khairy, Paul" sort="Khairy, Paul" uniqKey="Khairy P" first="Paul" last="Khairy">Paul Khairy</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Adult Congenital Heart Center, Montreal Heart Institute, Universite de Montreal</s1><s2>Montreal, Quebec</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>16 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Montreal, Quebec</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Boston Adult Congenital Heart Service, Children's Hospital Boston and Brigham and Women's Hospital</s1><s2>Boston, MA</s2><s3>USA</s3><sZ>2 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ><sZ>15 aut.</sZ><sZ>16 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Boston, MA</wicri:noRegion></affiliation></author></analytic><series><title level="j" type="main">Circulation : (New York, N.Y.)</title><title level="j" type="abbreviated">Circulation : (N. Y. N.Y.)</title><idno type="ISSN">0009-7322</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Circulation : (New York, N.Y.)</title><title level="j" type="abbreviated">Circulation : (N. Y. N.Y.)</title><idno type="ISSN">0009-7322</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aorta</term><term>Aortic regurgitation</term><term>Aortic valve</term><term>Cardiovascular disease</term><term>Congenital</term><term>Dilatation</term><term>Fallot tetralogy</term><term>Multicenter study</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Tétralogie de Fallot</term><term>Insuffisance aortique</term><term>Pathologie de l'appareil circulatoire</term><term>Aorte</term><term>Dilatation</term><term>Etude multicentrique</term><term>Congénital</term><term>Valvule aortique</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background-Although aortic root pathology has been described in patients with tetralogy of Fallot, the scope of the problem remains poorly defined. We sought to determine the prevalence and predictors of aortic root dilatation in adults with repaired tetralogy of Fallot. Methods and Results-A multicenter cross-sectional study was conducted with standardized reassessment of echocardiographic parameters in 474 adults (≥18 years) with surgically repaired tetralogy of Fallot or pulmonary atresia with ventricular septal defect. The aortic root was measured in a parasternal long-axis view, in diastole, at the level of the sinus of Valsalva. Prevalence and predictors of an absolute diameter ≥40 mm and of an observed-to-expected ratio >1.5 were assessed. The aortic root dimension was ≥40 mm in 28.9% (95% confidence interval, 26.9%-30.9%). In multivariate analyses, the only independently associated factor was male sex (odds ratio, 4.48; 95% confidence interval, 1.55-12.89; P=0.006). The prevalence of an observed-to-expected aortic root dimension ratio >1.5 was 6.6% (95% confidence interval, 5.3%-7.9%). It was associated with pulmonary atresia and moderate or severe aortic regurgitation in univariate analyses, but no independent predictor was identified. The side of the aortic arch was not associated with aortic root dimension. The prevalence of moderate or severe aortic regurgitation was 3.5% (95% confidence interval, 2.7%-4.2%). Conclusions-Although nearly one third of adults with repaired tetralogy of Fallot have an aortic root diameter ≥40 mm, the prevalence of a dilated aortic root, when defined by an indexed ratio of observed-to-expected values, is low. Similarly, moderate or severe aortic regurgitation is uncommon.</div></front></TEI><affiliations><list><country><li>Canada</li><li>États-Unis</li></country><region><li>Pennsylvanie</li></region><settlement><li>University Park (Pennsylvanie)</li></settlement><orgName><li>Université d'État de Pennsylvanie</li></orgName></list><tree><country name="Canada"><noRegion><name sortKey="Mongeon, Francois Pierre" sort="Mongeon, Francois Pierre" uniqKey="Mongeon F" first="François-Pierre" last="Mongeon">François-Pierre Mongeon</name></noRegion><name sortKey="Khairy, Paul" sort="Khairy, Paul" uniqKey="Khairy P" first="Paul" last="Khairy">Paul Khairy</name></country><country name="États-Unis"><noRegion><name sortKey="Gurvitz, Michelle Z" sort="Gurvitz, Michelle Z" uniqKey="Gurvitz M" first="Michelle Z." last="Gurvitz">Michelle Z. Gurvitz</name></noRegion><name sortKey="Aboulhosn, Jamil" sort="Aboulhosn, Jamil" uniqKey="Aboulhosn J" first="Jamil" last="Aboulhosn">Jamil Aboulhosn</name><name sortKey="Broberg, Craig S" sort="Broberg, Craig S" uniqKey="Broberg C" first="Craig S." last="Broberg">Craig S. Broberg</name><name sortKey="Cook, Stephen C" sort="Cook, Stephen C" uniqKey="Cook S" first="Stephen C." last="Cook">Stephen C. Cook</name><name sortKey="Earing, Michael G" sort="Earing, Michael G" uniqKey="Earing M" first="Michael G." last="Earing">Michael G. Earing</name><name sortKey="Fernandes, Susan M" sort="Fernandes, Susan M" uniqKey="Fernandes S" first="Susan M." last="Fernandes">Susan M. Fernandes</name><name sortKey="Gersony, Deborah R" sort="Gersony, Deborah R" uniqKey="Gersony D" first="Deborah R." last="Gersony">Deborah R. Gersony</name><name sortKey="Grando Ting, Jennifer" sort="Grando Ting, Jennifer" uniqKey="Grando Ting J" first="Jennifer" last="Grando Ting">Jennifer Grando Ting</name><name sortKey="Kay, Joseph D" sort="Kay, Joseph D" uniqKey="Kay J" first="Joseph D." last="Kay">Joseph D. Kay</name><name sortKey="Khairy, Paul" sort="Khairy, Paul" uniqKey="Khairy P" first="Paul" last="Khairy">Paul Khairy</name><name sortKey="Landzberg, Michael J" sort="Landzberg, Michael J" uniqKey="Landzberg M" first="Michael J." last="Landzberg">Michael J. Landzberg</name><name sortKey="Lui, George K" sort="Lui, George K" uniqKey="Lui G" first="George K." last="Lui">George K. Lui</name><name sortKey="Nickolaus, Michelle J" sort="Nickolaus, Michelle J" uniqKey="Nickolaus M" first="Michelle J." last="Nickolaus">Michelle J. Nickolaus</name><name sortKey="Opotowsky, Alexander R" sort="Opotowsky, Alexander R" uniqKey="Opotowsky A" first="Alexander R." last="Opotowsky">Alexander R. Opotowsky</name><name sortKey="Valente, Anne Marie" sort="Valente, Anne Marie" uniqKey="Valente A" first="Anne Marie" last="Valente">Anne Marie Valente</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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