Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-23T11:05:58.673Z Has data issue: false hasContentIssue false
  • English
  • Français

Two-dimensional echocardiographic predictors of coarctation of the aorta

Published online by Cambridge University Press:  16 October 2013

Ali A. Al Akhfash ,
Abdulrahman A. Almesned ,
Badr F. Al Harbi ,
Abdullah Al Ghamdi ,
Maan Hasson  and
Fahad M. Al Habshan
Ali A. Al Akhfash
Affiliation:
Pediatric Cardiology Department, Prince Sultan Cardiac Center-Qassim, MCH BuraidahAl-Qassim, Kingdom of Saudi Arabia
Abdulrahman A. Almesned
Affiliation:
Pediatric Cardiology Department, Prince Sultan Cardiac Center-Qassim, MCH BuraidahAl-Qassim, Kingdom of Saudi Arabia
Badr F. Al Harbi
Affiliation:
Pediatric Cardiology Department, Prince Sultan Cardiac Center-Qassim, MCH BuraidahAl-Qassim, Kingdom of Saudi Arabia
Abdullah Al Ghamdi
Affiliation:
Pediatric Cardiology Department, Prince Sultan Cardiac Center-Qassim, MCH BuraidahAl-Qassim, Kingdom of Saudi Arabia
Maan Hasson
Affiliation:
Pediatric Cardiology Department, Prince Sultan Cardiac Center-Qassim, MCH BuraidahAl-Qassim, Kingdom of Saudi Arabia
Fahad M. Al Habshan
Affiliation:
Pediatric Cardiology Department, Prince Sultan Cardiac Center-Qassim, MCH BuraidahAl-Qassim, Kingdom of Saudi Arabia
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: Coarctation of the aorta is a very common congenital heart malformation. It is frequently associated with other abnormalities. Echocardiography is the diagnostic modality for congenital heart disease. The carotid-subclavian artery index and the isthmus/descending aorta index were proposed for establishing the diagnosis of coarctation of the aorta. Objectives: The objectives were to evaluate such indexes and to look for other echocardiographic predictors of coarctation of the aorta. Method Echocardiography was reviewed for infants with coarctation of the aorta, as well as a control group, using the Echo PAC Dimension. Standard measurements were obtained from different sites of the aortic arch. Results: A total of 31 infants 3 months or less with coarctation of the aorta and 50 infants with no coarctation of the aorta were reviewed. Abnormal aortic valve was present in 65% of those with coarctation of the aorta. The diameters of the proximal and the distal transverse aortic arch were smaller in the coarctation of the aorta group. The distance between the aortic arch branches was longer in the coarctation of the aorta group. Apart from the ratio between distance 2 and the ascending aorta, other ratios/indexes were smaller in the coarctation of the aorta group than in the control group. Conclusion: The presence of abnormal aortic valve, a carotid subclavian index <1.1, I/AAo ratio <0.53, and DTA/AAo ratio <0.6 suggest the presence of coarctation of the aorta. Neonates with large patent ductus arteriosus and any of these findings need close observation until the patent ductus arteriosus closes. If the arch is difficult to assess by two-dimensional echocardiography, the patient may need further imaging to rule out coarctation of the aorta.

Keywords

Coarctation of the aortatwo-dimensional echocardiographycarotid subclavian indexcongenital heart diseasePrince Sultan Cardiac CenterQassim
Type
Original Articles
Information
Cardiology in the Young , Volume 25 , Issue 1 , January 2015 , pp. 87 - 94
Copyright
Copyright &#x00A9; Cambridge University Press 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Anderson, R, Baker, EJ, Macartney, FJ, Rigby, ML, Shinebourne, EA, Tynan, M. (eds). Paediatric Cardiology, 2nd edn. Churchill Livingstone, London, 2002.Google Scholar
2. Becker, AE, Becker, MJ, Edwards, JE. Anomalies associated with coarctation of aorta particular reference to infancy. Circulation 1970; 41: 1067–1075.CrossRefGoogle ScholarPubMed
3. Teo, LL, Cannell, T, Babu-Narayan, SV, Hughes, M, Mohiaddin, RH. Prevalence of associated cardiovascular abnormalities in 500 patients with aortic coarctation referred for cardiovascular magnetic resonance imaging to a tertiary centre. Pediatr Cardiol 2011; 32: 1120–1127.Google Scholar
4. Lai, WW, Geva, T, Shirali, GS, et al. Guidelines and standards for performance of a paediatric echocardiogram: a report from the Task Force of the Paediatric Council of the American Society of Echocardiography. J Am Soc Echocardiogr 2006; 19: 1413–1430.Google Scholar
5. Mertens, L, Ganame, J, Eyskens, B. What is new in paediatric cardiac imaging? Eur J Pediatr 2008; 167: 1–8.CrossRefGoogle ScholarPubMed
6. Kenny, D, Hijazi, Z. Coarctation of the aorta: from fetal life to adulthood. Cardiol J 2011; 18: 487–495.Google Scholar
7. Fesseha, AK, Eidem, BW, Dibardino, DJ, et al. Neonates with aortic coarctation and cardiogenic shock: presentation and outcomes. Ann Thorac Surg 2005; 79: 1650–1655.CrossRefGoogle ScholarPubMed
8. Dodge-Khatami, A, Ott, S, Di Bernardo, S, Berger, F. Carotid-subclavian artery index: new echocardiographic index to detect coarctation in neonates and infants. Ann Thorac Surg 2005; 80: 1652–1658.Google Scholar
9. Glancy, DL, Morrow, AG, Simon, AL, Roberts, WC. Juxtaductal aortic coarctation. Analysis of 84 patients studied hemodynamically, angiographically, and morphologically after age 1 year. Am J Cardiol 1983; 51: 537–551.Google Scholar
10. Morrow, WR, Huhta, JC, Murphy, DJ Jr, McNamara, DG. Quantitative morphology of the aortic arch in neonatal coarctation. J Am Coll Cardiol 1986; 8: 616–620.Google Scholar
11. Lu, CW, Wang, JK, Chang, CI, et al. Noninvasive diagnosis of aortic coarctation in neonates with patent ductus arteriosus. J Pediatr 2006; 148: 217–221.CrossRefGoogle ScholarPubMed
12. Mivelax, Y, Di Bernardo, S, Meijboom, EJ, Sekarski, N. Validation of two echocardiographic indexes to improve the diagnosis of complex coarctations. Eur J Cardiothorac Surg 2008; 34: 1051–1056.Google Scholar
13. Lopez, L, Colan, SD, Frommelt, PC, et al. Recommendations for quantification methods during the performance of a paediatric echocardiogram: a report from the Paediatric Measurements Writing Group of the American Society of Echocardiography Paediatric and Congenital Heart Disease Council. J Am Soc Echocardiogr 2010; 23: 465–495.Google Scholar
14. Petros, N, Spilios, K, Ralph, N, Katherine, H, Rodney, F. Accuracy of two-dimensional echocardiography in the diagnosis of aortic arch obstruction. J Am Coll CardioI 1987; 10: 1072.Google Scholar
15. Jaquiss, RD, Frommelt, PC. Invited commentary. Ann Thorac Surg 2005; 80: 1657–1658.Google Scholar
16. Houston, AB, Simpson, IA, Pollock, JC, Jamieson, MP, Doig, WB, Coleman, EN. Doppler ultrasound in the assessment of severity of coarctation of the aorta and interruption of the aortic arch. Br Heart J 1987; 57: 38–43.Google Scholar