TY - JOUR
T1 - Incidence of aneurysm formation after dacron patch aortoplasty repair for coarctation of the aorta
T2 - Long-term results and assessment utilizing magnetic resonance angiography with three-dimensional surface rendering
AU - Parks, Willie James
AU - Ngo, Thang D.
AU - Plauth, William H.
AU - Bank, Estelle R.
AU - Sheppard, Scott K.
AU - Pettigrew, Roderic I.
AU - Williams, Willis H.
N1 - Funding Information:
Dacron patch aortoplasty gained popularity in the mid-1960s because of its excellent gradient resolution and because it avoided sacrifice of intercostal arteries and minimized rcsten-osis by eliminating circumferential suture lines (1). During this period, Dacron patch aortoplasty technique was extensively used by many institutions for repair of coarctation of the aorta. Late aneurysm formation, a most serious postoperative and life-threatening complication, has led many institutions, including our own, to abandon the technique (2,3). The incidence of aneurysm formation after Dacron patch aortoplasty From The Children's Heart Center: : Egleston Children's Hospitala t Emorv University: and tDepartments of Medical Systems and Radiology, Emory University Hospital, Atlanta. Georgia. This study was supported in part by the Children's Research Center at Emnry University,A tlanta, Georgia. Manuscript received June 7, 1994: revised manuscript received February 3, 1995, accepted February 27, 1995. Address for correspondence: Dr. Willie James Parks. The Children's fteart Center at EmoW Universitv,2 040 Ridgewood Drive, Northcast, Atlanta, Oeur-gia 30322.
PY - 1995/7
Y1 - 1995/7
N2 - Objectives.: Magnetic resonance angiography with three-dimensional surface rendering was performed to determine its value in assessing anatomic detail in patients with suspected aortic aneurysms. Background.: Dacron patch aortoplasty repair of coaretation of the aorta carries an inherent risk of aneurysm development. Sudden death from aortic rupture prompted discontinuing this operation and evaluating 39 patients (16 girls; mean age 6.3 years, range 10 days to 14.5 years) undergoing repair between January 1976 and October 1987. The aorta ruptured in 10 patients; 6 died at a mean interval of 8.1 years (range 0.75 to 12.4) after repair. All 33 survivors were interviewed and examined. Methods.: Conventional magnetic resonance imaging was performed in 26 patients, magnetic resonance angiography in 18. Angiographic slices were used to reconstruct three-dimensional images. No catheterization or contrast angiography was performed. Surgical intervention was based on clinical findings and magnetic resonance images. Results.: Twenty patients (11 girls) developed aneurysms, of which nine were detected in patients studied by magnetic resonance. Ruptures occurred in eight female patients, three of whom were pregnant. Surface renderings accurately defined aortic anatomy or aneurysms in all patients. On follow-up, no aneurysms have been detected in patients with negative magnetic resonance study results. Precise anatomic correlation with operative findings was reported. Conclusions.: Magnetic resonance angiography with three-dimensional surface rendering provides noninvasive, radiation-free and contrast agent-free high resolution images of the thoracic aorta. These images can be reviewed and have three-dimensional form and perspective. These techniques were preferred over invasive angiography by surgeons and clinicians as definitive, risk-free procedures before surgical intervention.
AB - Objectives.: Magnetic resonance angiography with three-dimensional surface rendering was performed to determine its value in assessing anatomic detail in patients with suspected aortic aneurysms. Background.: Dacron patch aortoplasty repair of coaretation of the aorta carries an inherent risk of aneurysm development. Sudden death from aortic rupture prompted discontinuing this operation and evaluating 39 patients (16 girls; mean age 6.3 years, range 10 days to 14.5 years) undergoing repair between January 1976 and October 1987. The aorta ruptured in 10 patients; 6 died at a mean interval of 8.1 years (range 0.75 to 12.4) after repair. All 33 survivors were interviewed and examined. Methods.: Conventional magnetic resonance imaging was performed in 26 patients, magnetic resonance angiography in 18. Angiographic slices were used to reconstruct three-dimensional images. No catheterization or contrast angiography was performed. Surgical intervention was based on clinical findings and magnetic resonance images. Results.: Twenty patients (11 girls) developed aneurysms, of which nine were detected in patients studied by magnetic resonance. Ruptures occurred in eight female patients, three of whom were pregnant. Surface renderings accurately defined aortic anatomy or aneurysms in all patients. On follow-up, no aneurysms have been detected in patients with negative magnetic resonance study results. Precise anatomic correlation with operative findings was reported. Conclusions.: Magnetic resonance angiography with three-dimensional surface rendering provides noninvasive, radiation-free and contrast agent-free high resolution images of the thoracic aorta. These images can be reviewed and have three-dimensional form and perspective. These techniques were preferred over invasive angiography by surgeons and clinicians as definitive, risk-free procedures before surgical intervention.
UR - http://www.scopus.com/inward/record.url?scp=0029051941&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0029051941&partnerID=8YFLogxK
U2 - 10.1016/0735-1097(95)00127-L
DO - 10.1016/0735-1097(95)00127-L
M3 - Article
C2 - 7797761
AN - SCOPUS:0029051941
SN - 0735-1097
VL - 26
SP - 266
EP - 271
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 1
ER -