Thoracic Aortic Dissection in Tetralogy of Fallot: A Review of the National Inpatient Sample Database.

Published on Mar 19, 2019in Journal of the American Heart Association4.605
· DOI :10.1161/JAHA.119.011943
Alexander C. Egbe20
Estimated H-index: 20
(Mayo Clinic),
Juan A. Crestanello26
Estimated H-index: 26
(Mayo Clinic)
+ 1 AuthorsHeidi M. Connolly75
Estimated H-index: 75
(Mayo Clinic)
Background Thoracic aortic aneurysm is common in patients with tetralogy of Fallot (TOF); the incidence of thoracic aortic dissection (TAD) is unknown, but generally considered to be uncommon. The ...
#1Toshiyuki Yamada (Keio: Keio University)H-Index: 3
#2Takeshi Adachi (National Defense Medical College)H-Index: 19
Last. Hideyuki Shimizu (Keio: Keio University)H-Index: 22
view all 12 authors...
BACKGROUND: To obtain a saphenous vein graft (SVG) for coronary artery bypass grafting (CABG), the benefit of using a no-touch (NT) technique in vascular function has not been fully investigated. Methods and Results: The pathological and physiological functions of human SVGs with a NT technique to preserve the perivascular adipose tissue (PVAT) and ones obtained by using a conventional (CON) technique removing PVAT, were examined. Immunohistochemistry of the section of SVGs showed that the phosp...
3 CitationsSource
#1Michael A. Borger (Leipzig University)H-Index: 93
#2Paul W.M. Fedak (Libin Cardiovascular Institute of Alberta)H-Index: 54
Last. John A. Elefteriades (Yale University)H-Index: 77
view all 20 authors...
Abstract Bicuspid aortic valve disease is the most common congenital cardiac disorder, being present in 1% to 2% of the general population. Associated aortopathy is a common finding in patients with bicuspid aortic valve disease, with thoracic aortic dilation noted in approximately 40% of patients in referral centers. Several previous consensus statements and guidelines have addressed the management of bicuspid aortic valve–associated aortopathy, but none focused entirely on this disease process...
103 CitationsSource
#1Cristina Cruz (University of Porto)H-Index: 13
#2Teresa Pinho (University of Porto)H-Index: 13
Last. Maria Júlia Maciel (University of Porto)H-Index: 13
view all 6 authors...
BACKGROUND: Late after tetralogy of Fallot (TOF) repair some patients exhibit aortic dilatation and stiffness. Noninvasive assessment of aortic stiffness could contribute to understand this aortopathy and may be important in risk stratification for major aortic event. METHODS: We included prospectively 82 adults after TOF repair and 41 age- and sex-matched normal controls. Aortic diameters were measured by two-dimensional transthoracic echocardiography and the aortic z-score was estimated. Aorti...
10 CitationsSource
Although the high prevalence of aortic root dilatation in adults with repaired tetralogy of Fallot (rTOF) is well established [(1,2)][1], evidence to guide clinical follow-up and decision making remains sparse. We sought to define the features, determinants, and rate of progression of aortic
10 CitationsSource
#1Karen G. Ordovas (UCSF: University of California, San Francisco)H-Index: 21
#2Alexander W. Keedy (UCSF: University of California, San Francisco)H-Index: 7
Last. Michael D. Hope (UCSF: University of California, San Francisco)H-Index: 29
view all 8 authors...
To evaluate the association between aortic morphology and elasticity with aortic regurgitation in surgically corrected of tetralogy of Fallot (TOF) patients. We retrospectively identified 72 consecutive patients with surgically corrected TOF and 27 healthy controls who underwent cardiac MRI evaluation. Velocity-encoded cine MRI was used to quantify degree of aortic regurgitation (AR) in TOF patients. Ascending aorta diameters were measured at standard levels on MRA images. Aortic pulse-wave velo...
9 CitationsSource
#1Charles M. Wojnarski (Cleveland Clinic)H-Index: 5
#2Lars G. Svensson (Cleveland Clinic)H-Index: 96
Last. Bruce W. Lytle (Cleveland Clinic)H-Index: 130
view all 18 authors...
Background Data regarding the risk of aortic dissection in patients with bicuspid aortic valve and large ascending aortic diameter are limited, and appropriate timing of prophylactic ascending aortic replacement lacks consensus. Thus our objectives were to determine the risk of aortic dissection based on initial cross-sectional imaging data and clinical variables and to isolate predictors of aortic intervention in those initially prescribed serial surveillance imaging. Methods From January 1995 ...
55 CitationsSource
#1Shinobu Itagaki (ISMMS: Icahn School of Medicine at Mount Sinai)H-Index: 21
#2Joanna Chikwe (ISMMS: Icahn School of Medicine at Mount Sinai)H-Index: 32
Last. David H. Adams (ISMMS: Icahn School of Medicine at Mount Sinai)H-Index: 206
view all 5 authors...
Abstract Background Bicuspid aortic valves are associated with valve dysfunction, ascending aortic aneurysm and dissection. Management of the ascending aorta at the time of aortic valve replacement (AVR) in these patients is controversial and has been extrapolated from experience with Marfan syndrome, despite the absence of comparative long-term outcome data. Objectives This study sought to assess whether the natural history of thoracic aortopathy after AVR in patients with bicuspid aortic valve...
60 CitationsSource
#1Mark Dennis (USYD: University of Sydney)H-Index: 9
#2Maarit Laarkson (UNSW: University of New South Wales)H-Index: 1
Last. Rajesh Puranik (USYD: University of Sydney)H-Index: 21
view all 9 authors...
6 CitationsSource
#1Raimund ErbelH-Index: 140
#2AboyansH-Index: 1
Last. Christiaan J. VrintsH-Index: 61
view all 22 authors...
2,140 CitationsSource
#1Vishva A. Wijesekera (UBC: University of British Columbia)H-Index: 3
#2Marla Kiess (UBC: University of British Columbia)H-Index: 17
Last. Amanda J. Barlow (UBC: University of British Columbia)H-Index: 3
view all 7 authors...
With improved longevity, aortic root dilation has been increasingly recognized among patients with tetralogy of Fallot (TOF). Aortic dissection is thought to be rare with only three previous cases [1,3,2] reported in the literature. We describe the case of a patient who presented following aortic root dissection late after TOF repair. This 60 year old male had TOF repair at age 14, and was known to have a dilated aortic root. Infrequent (five yearly) transthoracic echocardiograms from 1999 to 20...
18 CitationsSource
Cited By11
#1Jennifer P Woo (Stanford University)
#2Doff B. McElhinney (Stanford University)H-Index: 24
Last. George K. Lui (Stanford University)H-Index: 17
view all 3 authors...
Introduction null Advancements in surgery and management have resulted in a growing population of aging adults with tetralogy of Fallot (TOF). As a result, there has been a parallel growth in late complications associated with the sequelae from the underlying cardiac anomalies as well as the surgical and other interventional treatments. null Areas covered null Here, we review challenges related to an aging population of patients with TOF, particularly late complications, and highlight advances i...
#1Yuli Y. Kim (UPenn: University of Pennsylvania)H-Index: 14
#2Max T. Geisinger (UPenn: University of Pennsylvania)H-Index: 1
Last. Elizabeth Goldmuntz (UPenn: University of Pennsylvania)H-Index: 61
view all 6 authors...
Abstract Background Aortic root dilation is described in tetralogy of Fallot (TOF) but few studies have examined the longitudinal trajectory of aortic root size over time. This study aims to evaluate changes in aortic root dimension across age in patients with repaired TOF and examine associated clinical characteristics. Methods Retrospective single-center study of TOF patients derived from a historical research cohort with up to 4 serial echocardiograms. Aortic dimensions at the annulus, sinus,...
2 CitationsSource
2 CitationsSource
Abstract Background: Aortic root dilatation is common in adults with repaired tetralogy of Fallot (rTOF) and might lead to aortic dissection. However, little is known on progression of aortic dilatation and the effect of pharmaceutical treatment. This study aims to determine factors associated with aortic growth and investigate effects of losartan. Methods and results: We performed a prespecified analysis from the 1:1 randomized, double-blind REDEFINE trial. Aortic root diameters were measured a...
#1Helmut BaumgartnerH-Index: 63
#2Julie De BackerH-Index: 44
Last. Bernard IungH-Index: 83
view all 53 authors...
177 CitationsSource
#1Pak-Cheong Chow (Queen Mary Hospital)H-Index: 9
#2Barnabe Antonio Rocha (Queen Mary Hospital)H-Index: 2
Last. Tak-cheung Yung (Queen Mary Hospital)H-Index: 14
view all 4 authors...
Abstract Aortic dilation has been increasingly recognized in congenital heart diseases, and aortic dissection is one of the important complications. We report a case of aortic dissection in a patient 31 years after repair of tetralogy of Fallot (TOF) and review reported cases. While aortic dissection is uncommon, aortic dilation is common among patients with repaired TOF and it appeared progressive in some patients. Based on the reported cases, progressive aortic dilation appeared as the pre-req...
1 CitationsSource
#1Timothy B. Cotts (UM: University of Michigan)H-Index: 10
#2Katherine B. Salciccioli (UM: University of Michigan)H-Index: 3
Last. Anji T. Yetman (UNMC: University of Nebraska Medical Center)H-Index: 11
view all 4 authors...
Aortic dilatation is common in patients with congenital heart disease and is seen in patients with bicuspid aortic valve and those with conotruncal congenital heart defects. It is important to identify patients with bicuspid aortic valve at high risk for aortic dissection. High-risk patients include those with the aortic root phenotype and those with syndromic or familial aortopathies including Marfan syndrome, Loeys-Dietz syndrome, and Turner syndrome. Aortic dilatation is common in patients wi...
#1Yosuke Nishimura (University of Occupational and Environmental Health Japan)H-Index: 6
#2Toru YasutsuneH-Index: 4
view all 7 authors...
BACKGROUND Aortic dilatation may occur in some patients even after complete repair of tetralogy of Fallot (TOF). The progression rate of the aortic diameter is so slow, and the incidence of aortic dissection is so low that it is suspected that frequent imaging of the aorta may not be necessary. CASE PRESENTATION We describe an asymptomatic 41-year-old man with hypertension in whom aortic dilatation was accidentally discovered 39 years after TOF repair. He underwent ambulatory follow-up without a...
#1Anna S. Mueller (NewYork–Presbyterian Hospital)H-Index: 1
#2Daniel M. McDonald (NewYork–Presbyterian Hospital)H-Index: 1
Last. Jonathan Ginns (Cornell University)H-Index: 9
view all 4 authors...
The number of rTOF patients who survive into adulthood is steadily rising, with currently more than 90% reaching the third decade of life. However, rTOF patients are not cured, but rather have a lifelong increased risk for cardiac and non-cardiac complications. Heart failure is recognized as a significant complication. Its occurrence is strongly associated with adverse outcome. Unfortunately, conventional concepts of heart failure may not be directly applicable in this patient group. This articl...
5 CitationsSource
#1Maryam Moradi (IUMS: Isfahan University of Medical Sciences)H-Index: 6
#2Raheleh Sadat Mirfasihi (IUMS: Isfahan University of Medical Sciences)
Introduction Thoracic aortic dissection is a probable fatal condition that requires early diagnosis and management. The underlying etiology of this disorder is an important issue that has not been completely responded yet. In the current study, the association between aortic root rotation and ascending aortic dissection has been assessed.