title: Echocardiographic assessment of the aortic root dilatation in adult patients after tetralogy of Fallot repair.
abstract: BACKGROUND
  Transthoracic echocardiography is an important tool after tetralogy of Fallot repair, of which aortic root dilatation is a recognized complication. In this study we aimed to assess its prevalence and potential predictors.
  
  
  METHODS
  We consecutively assessed adult patients by transthoracic echocardiography after tetralogy of Fallot repair, and divided them into two groups based on the maximum internal aortic diameter at the sinuses of Valsalva in parasternal long-axis view: group 1 with aortic root dilatation (≥38 mm) and group 2 without dilatation (<38 mm).
  
  
  RESULTS
  A total of 53 patients were included, mean age 32±10 years, with a mean time since surgery of 23±7 years. An aortopulmonary shunt had been performed prior to complete repair in 25 patients, and a transannular patch was used in 19 patients. Aortic root measurement was possible in all patients. Aortic root dilatation was identified in eight patients (15%), all male. Male gender (p=0.001), body surface area (1.93±0.10 vs. 1.70±0.20 m(2), p=0.03) and increased left ventricular end-diastolic diameter (p=0.005) were predictors of aortic root dilatation. None of the surgical variables studied were predictors of aortic root dilatation.
  
  
  CONCLUSIONS
  The prevalence of aortic root dilatation in this cohort was low and male gender was a predictor of its occurrence. The type of repair and time to surgery did not influence its occurrence. Quantification of aortic root diameter is possible by transthoracic echocardiography; we suggest indexing it to body surface area in clinical practice.
authors.affiliation: Serviço de Cardiologia, Centro Hospitalar São João, Porto, Portugal; Departamento de Medicina, Faculdade de Medicina do Porto, Porto, Portugal. mcristina.cruz@hsjoao.min-saude.pt
authors.forename: Cristina
authors.initials: C
authors.lastname: Cruz
authors.forename: Teresa
authors.initials: T
authors.lastname: Pinho
authors.forename: Ana
authors.initials: A
authors.lastname: Lebreiro
authors.forename: José
authors.initials: J
authors.lastname: Silva Cardoso
authors.forename: Maria Júlia
authors.initials: MJ
authors.lastname: Maciel
mesh_terms: D000328:Adult; D001021:Aortic Valve / Q000000981:diagnostic imaging; D000082882:Bicuspid Aortic Valve Disease; D004108:Dilatation, Pathologic; D005260:Female; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging* / Q000453:epidemiology; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000453:epidemiology; D015995:Prevalence; D013771:Tetralogy of Fallot / Q000601:surgery*; D014463:Ultrasonography
keywords: Aortic dilatation; Dilatação da aorta; Ecocardiograma transtorácico; Tetralogia de Fallot; Tetralogy of Fallot; Transthoracic echocardiography