Impairment of aortic elastic properties in patients with transposition of the great arteries post arterial switch operat
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Impairment of aortic elastic properties in patients with transposition of the great arteries post arterial switch operation Inga Voges*1, Christopher Hart1, Michael Jerosch-Herold2, Jürgen Hedderich3, Traudel Hansen1, Hans-Heiner Kramer1 and Carsten Rickers1 Address: 1Department of Paediatric Cardiology, University Hospital Schleswig-Holstein, Kiel, Germany, 2Department of Radiology, Brigham & Women's Hospital & Harvard Medical School, Boston, MA, USA and 3Department for Medical Informatics and Statistics, University Hospital Schleswig-Holstein, Kiel, Germany * Corresponding author
from 13th Annual SCMR Scientific Sessions Phoenix, AZ, USA. 21-24 January 2010 Published: 21 January 2010 Journal of Cardiovascular Magnetic Resonance 2010, 12(Suppl 1):P10
doi:10.1186/1532-429X-12-S1-P10
Abstracts of the 13th Annual SCMR Scientific Sessions - 2010
Meeting abstracts - A single PDF containing all abstracts in this Supplement is available here. http://www.biomedcentral.com/content/files/pdf/1532-429X-11-S1-infoThis abstract is available from: http://jcmr-online.com/content/12/S1/P10 © 2010 Voges et al; licensee BioMed Central Ltd.
Introduction The arterial switch operation (ASO) is now the standard of care for palliation of dextro transposition of the great arteries (d-TGA). The status of the transposed aorta (Ao) is considered an important determinant for long-term prognosis.
Purpose To assess the bioelastic properties of the thoracic Ao through measurement of distensibility and pulse wave velocity (PWV), and to identify risk factors associated with reduced aortic elasticity.
Methods Fourty-two d-TGA patients (median 15, range 0.5-31.0 years) were examined with 3.0 T MRI. 26 patients had simple transposition and 16 patients had additional risk factors (ventricular septal defect (VSD) n = 7, aortic coarctation n = 3, prior pulmonary artery banding n = 5, and ASO without Lecompte maneuver n = 1). 34 heart healthy subjects were enrolled as controls (median 11.4, range 2.3-31.3 years). Gradient-echo cine MRI (FOV 280 × 224 mm, voxel size 1.88 × 1.94 × 6 mm, TR = 4.4 ms, TE = 2.5 ms, flip angle: 15°) was used to determine aortic distensibility at three levels (ascending, proximal and distal descending Ao)
with the following formula: (Amax - Amin)/[Amin × (Pmax - Pmin)]; A = cross-sectional aortic lumen area, P = blood pressure. Phase contrast MRI flow measurements (FOV 270 × 270 mm, voxel size 1.64 × 1.4 × 7 mm, TR = 4.4 ms, TE = 2.7 ms, velocity encoding (VENC) = 200 cm/ s) in the ascending and descending Ao served to assess regurgitant fraction (RGF) of the aortic valve and PWV, calculated as the ratio of the distance between the ascending and descending Ao and the time delay of the systolic velocity up-stroke between proximal and distal locations.
Results Distensibility of the ascending (3.9 ± 2.9 10-3 mmHg-1 vs 10.8 ± 5.5 10-3 mmHg-1, p < 0.01) and proximal descending Ao (7.1 ± 3.0 vs 9.0 ± 5.1, p < 0.01) was significantly reduced in d-TGA compared with c
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