Magnetic resonance imaging demonstration of “Remodeling” of the aorta following balloon angioplasty of discrete native coarctation |
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Authors: | H S Weber T Mosher R Mahraj B G Baylen |
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Institution: | (1) Department of Pediatrics (Cardiology), The Pennsylvania State University Childrens Hospital, PO Box 850, Hershey, PA 17033, USA, US;(2) Department of Radiology, The Pennsylvania State University Childrens Hospital, PO Box 850, Hershey, PA 17033, USA, US |
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Abstract: | Assessment of the hemodynamic and anatomic results following balloon angioplasty of discrete native coarctation of the aorta,
with particular attention to ``remodeling,' has required repeat cardiac catheterization and angiography, which is invasive
and has limited resolution. Eight patients with hypertension and discrete native coarctation with an otherwise normally developed
aortic arch underwent angioplasty at 5.0 ± 6.8 years of age. Angiographic cross-sectional areas of the aorta indexed to body
surface area at the isthmus (I), coarctation site (C), and 1 cm distal to the coarctation site (Cd) pre- and postangioplasty
were compared with MRI-indexed cross-sectional areas 18 ± 10 months (MRI-1) and 35 ± 11 months (MRI-2) postangioplasty. From
preangioplasty to MRI-2, the isthmus was smaller (149 ± 22 versus 127 ± 27 mm2/m2; p < 0.05). The coarctation site was larger postangioplasty (25 ± 9 versus 116 ± 40 mm2/m2; p < 0.001) with continued growth at latest follow-up (116 ± 40 versus 164 ± 36 mm2/m2; p < 0.01). The segment 1 cm distal to the coarctation site continued to decrease in area at latest follow-up (267 ± 78 versus
163 ± 38 mm2/m2; p < 0.001). I versus C versus Cd at MRI-2 were similar, whereas postangioplasty and MRI-1 cross-sectional area measurements
were significantly different. Following angioplasty of discrete native coarctation, the aorta becomes more uniform or undergoes
``remodeling.' Noninvasive MRI is an effective means of evaluating the anatomic result following balloon angioplasty, obviating
the need for repeated invasive cardiac catheterizations. |
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Keywords: | : Aortic coarctation — Balloon angioplasty — Remodeling |
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