Screening for Aortic Aneurysm After Treatment of Coarctation
Isolated coarctation of the aorta (CoA) occurs in 6–8 % of patients with congenital heart disease. After successful relief of obstruction, patients remain at risk for aortic aneurysm formation at the site of the repair. We sought to determine the diagnostic utility of echocardiography compared with...
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| creator | Hoffman, James L. Gray, Robert G. LuAnn Minich, L. Wilkinson, Stephen E. Heywood, Mason Edwards, Reggie Weng, Hsin Ti Su, Jason T. |
| description | Isolated coarctation of the aorta (CoA) occurs in 6–8 % of patients with congenital heart disease. After successful relief of obstruction, patients remain at risk for aortic aneurysm formation at the site of the repair. We sought to determine the diagnostic utility of echocardiography compared with advanced arch imaging (AAI) in diagnosing aortic aneurysms in pediatric patients after CoA repair. The Congenital Heart Databases from 1996 and 2009 were reviewed. All patients treated for CoA who had AAI defined by cardiac magnetic resonance imaging (MRI), computed tomography (CT), or catheterization were identified. Data collected included the following: type, timing, and number of interventions, presence and time to aneurysm diagnosis, and mortality. Patients were subdivided into surgical and catheterization groups for analysis. Seven hundred and fifty-nine patients underwent treatment for CoA during the study period. Three hundred and ninety-nine patients had at least one AAI. Aneurysms were diagnosed by AAI in 28 of 399 patients at a mean of 10 ± 8.4 years after treatment. Echocardiography reports were available for 380 of 399 patients with AAI. The sensitivity of echocardiography for detecting aneurysms was 24 %. The prevalence of aneurysms was significantly greater in the catheterization group (
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| doi_str_mv | 10.1007/s00246-013-0737-x |
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| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_1490712275</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A715520124</galeid><sourcerecordid>A715520124</sourcerecordid><originalsourceid>FETCH-LOGICAL-c411t-f9a2fa2cc778a5321660a29d55595c84e9b5dc8b73d2db615acccb95e15e679e3</originalsourceid><addsrcrecordid>eNp9kU1r3DAQhkVpabZJf0AvxdBLL05mZMuyoBez9AsCOTQ5C1keLQ5rKZVkSP59tTgtFEqZw8DM8w4z8zL2DuESAeRVAuBtVwM2NchG1o8v2A7bhteoJL5kO0DJa-ja5oy9SekeAHroxWt2xhupWkC-Y59-2EjkZ3-oXIjVEGKebTV4WuNTWqrBZYrVbSSTF_K5Cq7aBxNtNnkO_oK9cuaY6O1zPmd3Xz7f7r_V1zdfv--H69q2iLl2ynBnuLVS9kY0HLsODFeTEEIJ27ekRjHZfpTNxKexQ2GstaMShII6qag5Zx-3uQ8x_FwpZb3MydLxaDyFNWlsFUjkXIqCftjQgzmSnr0LORp7wvUgUQherm4LdfkPqsREy2yDJzeX-l8C3AQ2hpQiOf0Q58XEJ42gT17ozQtdvNAnL_Rj0bx_3nodF5r-KH4_vwB8A1Jp-QNFfR_W6Msn_zP1F4Ljkm0</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1490712275</pqid></control><display><type>article</type><title>Screening for Aortic Aneurysm After Treatment of Coarctation</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Hoffman, James L. ; Gray, Robert G. ; LuAnn Minich, L. ; Wilkinson, Stephen E. ; Heywood, Mason ; Edwards, Reggie ; Weng, Hsin Ti ; Su, Jason T.</creator><creatorcontrib>Hoffman, James L. ; Gray, Robert G. ; LuAnn Minich, L. ; Wilkinson, Stephen E. ; Heywood, Mason ; Edwards, Reggie ; Weng, Hsin Ti ; Su, Jason T.</creatorcontrib><description>Isolated coarctation of the aorta (CoA) occurs in 6–8 % of patients with congenital heart disease. After successful relief of obstruction, patients remain at risk for aortic aneurysm formation at the site of the repair. We sought to determine the diagnostic utility of echocardiography compared with advanced arch imaging (AAI) in diagnosing aortic aneurysms in pediatric patients after CoA repair. The Congenital Heart Databases from 1996 and 2009 were reviewed. All patients treated for CoA who had AAI defined by cardiac magnetic resonance imaging (MRI), computed tomography (CT), or catheterization were identified. Data collected included the following: type, timing, and number of interventions, presence and time to aneurysm diagnosis, and mortality. Patients were subdivided into surgical and catheterization groups for analysis. Seven hundred and fifty-nine patients underwent treatment for CoA during the study period. Three hundred and ninety-nine patients had at least one AAI. Aneurysms were diagnosed by AAI in 28 of 399 patients at a mean of 10 ± 8.4 years after treatment. Echocardiography reports were available for 380 of 399 patients with AAI. The sensitivity of echocardiography for detecting aneurysms was 24 %. The prevalence of aneurysms was significantly greater in the catheterization group (
p
< 0.05) compared with the surgery group. Aneurysm was also diagnosed earlier in the catheterization group compared with the surgery group (
p
= 0.02). Multivariate analysis showed a significantly increased risk of aneurysm diagnosis in patients in the catheterization subgroup and in patients requiring more than three procedures. Aortic aneurysms continue to be an important complication after CoA repair. Although serial echocardiograms are the test of choice for following-up most congenital cardiac lesions in pediatrics, our data show that echocardiography is inadequate for the detection of aneurysms after CoA repair. Because the time to aneurysm diagnosis was shorter and the risk greater in the catheterization group (particularly for patients requiring more than one procedure), surveillance with cardiac MRI or CT should begin earlier in these patients.</description><identifier>ISSN: 0172-0643</identifier><identifier>EISSN: 1432-1971</identifier><identifier>DOI: 10.1007/s00246-013-0737-x</identifier><identifier>PMID: 23794012</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject><![CDATA[Adolescent ; Aortic Aneurysm, Thoracic - diagnosis ; Aortic Aneurysm, Thoracic - etiology ; Aortic Aneurysm, Thoracic - mortality ; Aortic Aneurysm, Thoracic - surgery ; Aortic aneurysms ; Aortic Coarctation - diagnosis ; Aortic Coarctation - epidemiology ; Aortic Coarctation - surgery ; Cardiac Catheterization - adverse effects ; Cardiac Catheterization - methods ; Cardiac Catheterization - statistics & numerical data ; Cardiac patients ; Cardiac Surgery ; Cardiology ; Catheterization ; Child ; Child, Preschool ; Children ; Comparative analysis ; Comparative Effectiveness Research ; Congenital heart disease ; Echocardiography - methods ; Echocardiography - statistics & numerical data ; Female ; Genetic disorders ; Health aspects ; Heart ; Heart diseases ; Humans ; Magnetic Resonance Imaging - methods ; Magnetic Resonance Imaging - statistics & numerical data ; Male ; Mass Screening ; Medicine ; Medicine & Public Health ; Mortality ; Original Article ; Postoperative Complications - diagnosis ; Postoperative Complications - mortality ; Postoperative Complications - surgery ; Prevalence ; Reoperation ; Retrospective Studies ; Risk Assessment ; Time-to-Treatment ; Tomography, X-Ray Computed - methods ; Tomography, X-Ray Computed - statistics & numerical data ; United States - epidemiology ; Vascular Surgery ; Vascular Surgical Procedures - adverse effects ; Vascular Surgical Procedures - methods ; Vascular Surgical Procedures - statistics & numerical data]]></subject><ispartof>Pediatric cardiology, 2014, Vol.35 (1), p.47-52</ispartof><rights>Springer Science+Business Media New York 2013</rights><rights>COPYRIGHT 2014 Springer</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c411t-f9a2fa2cc778a5321660a29d55595c84e9b5dc8b73d2db615acccb95e15e679e3</citedby><cites>FETCH-LOGICAL-c411t-f9a2fa2cc778a5321660a29d55595c84e9b5dc8b73d2db615acccb95e15e679e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00246-013-0737-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00246-013-0737-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23794012$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hoffman, James L.</creatorcontrib><creatorcontrib>Gray, Robert G.</creatorcontrib><creatorcontrib>LuAnn Minich, L.</creatorcontrib><creatorcontrib>Wilkinson, Stephen E.</creatorcontrib><creatorcontrib>Heywood, Mason</creatorcontrib><creatorcontrib>Edwards, Reggie</creatorcontrib><creatorcontrib>Weng, Hsin Ti</creatorcontrib><creatorcontrib>Su, Jason T.</creatorcontrib><title>Screening for Aortic Aneurysm After Treatment of Coarctation</title><title>Pediatric cardiology</title><addtitle>Pediatr Cardiol</addtitle><addtitle>Pediatr Cardiol</addtitle><description>Isolated coarctation of the aorta (CoA) occurs in 6–8 % of patients with congenital heart disease. After successful relief of obstruction, patients remain at risk for aortic aneurysm formation at the site of the repair. We sought to determine the diagnostic utility of echocardiography compared with advanced arch imaging (AAI) in diagnosing aortic aneurysms in pediatric patients after CoA repair. The Congenital Heart Databases from 1996 and 2009 were reviewed. All patients treated for CoA who had AAI defined by cardiac magnetic resonance imaging (MRI), computed tomography (CT), or catheterization were identified. Data collected included the following: type, timing, and number of interventions, presence and time to aneurysm diagnosis, and mortality. Patients were subdivided into surgical and catheterization groups for analysis. Seven hundred and fifty-nine patients underwent treatment for CoA during the study period. Three hundred and ninety-nine patients had at least one AAI. Aneurysms were diagnosed by AAI in 28 of 399 patients at a mean of 10 ± 8.4 years after treatment. Echocardiography reports were available for 380 of 399 patients with AAI. The sensitivity of echocardiography for detecting aneurysms was 24 %. The prevalence of aneurysms was significantly greater in the catheterization group (
p
< 0.05) compared with the surgery group. Aneurysm was also diagnosed earlier in the catheterization group compared with the surgery group (
p
= 0.02). Multivariate analysis showed a significantly increased risk of aneurysm diagnosis in patients in the catheterization subgroup and in patients requiring more than three procedures. Aortic aneurysms continue to be an important complication after CoA repair. Although serial echocardiograms are the test of choice for following-up most congenital cardiac lesions in pediatrics, our data show that echocardiography is inadequate for the detection of aneurysms after CoA repair. Because the time to aneurysm diagnosis was shorter and the risk greater in the catheterization group (particularly for patients requiring more than one procedure), surveillance with cardiac MRI or CT should begin earlier in these patients.</description><subject>Adolescent</subject><subject>Aortic Aneurysm, Thoracic - diagnosis</subject><subject>Aortic Aneurysm, Thoracic - etiology</subject><subject>Aortic Aneurysm, Thoracic - mortality</subject><subject>Aortic Aneurysm, Thoracic - surgery</subject><subject>Aortic aneurysms</subject><subject>Aortic Coarctation - diagnosis</subject><subject>Aortic Coarctation - epidemiology</subject><subject>Aortic Coarctation - surgery</subject><subject>Cardiac Catheterization - adverse effects</subject><subject>Cardiac Catheterization - methods</subject><subject>Cardiac Catheterization - statistics & numerical data</subject><subject>Cardiac patients</subject><subject>Cardiac Surgery</subject><subject>Cardiology</subject><subject>Catheterization</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Comparative analysis</subject><subject>Comparative Effectiveness Research</subject><subject>Congenital heart disease</subject><subject>Echocardiography - methods</subject><subject>Echocardiography - statistics & numerical data</subject><subject>Female</subject><subject>Genetic disorders</subject><subject>Health aspects</subject><subject>Heart</subject><subject>Heart diseases</subject><subject>Humans</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Magnetic Resonance Imaging - statistics & numerical data</subject><subject>Male</subject><subject>Mass Screening</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mortality</subject><subject>Original Article</subject><subject>Postoperative Complications - diagnosis</subject><subject>Postoperative Complications - mortality</subject><subject>Postoperative Complications - surgery</subject><subject>Prevalence</subject><subject>Reoperation</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Time-to-Treatment</subject><subject>Tomography, X-Ray Computed - methods</subject><subject>Tomography, X-Ray Computed - statistics & numerical data</subject><subject>United States - epidemiology</subject><subject>Vascular Surgery</subject><subject>Vascular Surgical Procedures - adverse effects</subject><subject>Vascular Surgical Procedures - methods</subject><subject>Vascular Surgical Procedures - statistics & numerical data</subject><issn>0172-0643</issn><issn>1432-1971</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU1r3DAQhkVpabZJf0AvxdBLL05mZMuyoBez9AsCOTQ5C1keLQ5rKZVkSP59tTgtFEqZw8DM8w4z8zL2DuESAeRVAuBtVwM2NchG1o8v2A7bhteoJL5kO0DJa-ja5oy9SekeAHroxWt2xhupWkC-Y59-2EjkZ3-oXIjVEGKebTV4WuNTWqrBZYrVbSSTF_K5Cq7aBxNtNnkO_oK9cuaY6O1zPmd3Xz7f7r_V1zdfv--H69q2iLl2ynBnuLVS9kY0HLsODFeTEEIJ27ekRjHZfpTNxKexQ2GstaMShII6qag5Zx-3uQ8x_FwpZb3MydLxaDyFNWlsFUjkXIqCftjQgzmSnr0LORp7wvUgUQherm4LdfkPqsREy2yDJzeX-l8C3AQ2hpQiOf0Q58XEJ42gT17ozQtdvNAnL_Rj0bx_3nodF5r-KH4_vwB8A1Jp-QNFfR_W6Msn_zP1F4Ljkm0</recordid><startdate>2014</startdate><enddate>2014</enddate><creator>Hoffman, James L.</creator><creator>Gray, Robert G.</creator><creator>LuAnn Minich, L.</creator><creator>Wilkinson, Stephen E.</creator><creator>Heywood, Mason</creator><creator>Edwards, Reggie</creator><creator>Weng, Hsin Ti</creator><creator>Su, Jason T.</creator><general>Springer US</general><general>Springer</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>2014</creationdate><title>Screening for Aortic Aneurysm After Treatment of Coarctation</title><author>Hoffman, James L. ; Gray, Robert G. ; LuAnn Minich, L. ; Wilkinson, Stephen E. ; Heywood, Mason ; Edwards, Reggie ; Weng, Hsin Ti ; Su, Jason T.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c411t-f9a2fa2cc778a5321660a29d55595c84e9b5dc8b73d2db615acccb95e15e679e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adolescent</topic><topic>Aortic Aneurysm, Thoracic - diagnosis</topic><topic>Aortic Aneurysm, Thoracic - etiology</topic><topic>Aortic Aneurysm, Thoracic - mortality</topic><topic>Aortic Aneurysm, Thoracic - surgery</topic><topic>Aortic aneurysms</topic><topic>Aortic Coarctation - diagnosis</topic><topic>Aortic Coarctation - epidemiology</topic><topic>Aortic Coarctation - surgery</topic><topic>Cardiac Catheterization - adverse effects</topic><topic>Cardiac Catheterization - methods</topic><topic>Cardiac Catheterization - statistics & numerical data</topic><topic>Cardiac patients</topic><topic>Cardiac Surgery</topic><topic>Cardiology</topic><topic>Catheterization</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Children</topic><topic>Comparative analysis</topic><topic>Comparative Effectiveness Research</topic><topic>Congenital heart disease</topic><topic>Echocardiography - methods</topic><topic>Echocardiography - statistics & numerical data</topic><topic>Female</topic><topic>Genetic disorders</topic><topic>Health aspects</topic><topic>Heart</topic><topic>Heart diseases</topic><topic>Humans</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Magnetic Resonance Imaging - statistics & numerical data</topic><topic>Male</topic><topic>Mass Screening</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mortality</topic><topic>Original Article</topic><topic>Postoperative Complications - diagnosis</topic><topic>Postoperative Complications - mortality</topic><topic>Postoperative Complications - surgery</topic><topic>Prevalence</topic><topic>Reoperation</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Time-to-Treatment</topic><topic>Tomography, X-Ray Computed - methods</topic><topic>Tomography, X-Ray Computed - statistics & numerical data</topic><topic>United States - epidemiology</topic><topic>Vascular Surgery</topic><topic>Vascular Surgical Procedures - adverse effects</topic><topic>Vascular Surgical Procedures - methods</topic><topic>Vascular Surgical Procedures - statistics & numerical data</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hoffman, James L.</creatorcontrib><creatorcontrib>Gray, Robert G.</creatorcontrib><creatorcontrib>LuAnn Minich, L.</creatorcontrib><creatorcontrib>Wilkinson, Stephen E.</creatorcontrib><creatorcontrib>Heywood, Mason</creatorcontrib><creatorcontrib>Edwards, Reggie</creatorcontrib><creatorcontrib>Weng, Hsin Ti</creatorcontrib><creatorcontrib>Su, Jason T.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hoffman, James L.</au><au>Gray, Robert G.</au><au>LuAnn Minich, L.</au><au>Wilkinson, Stephen E.</au><au>Heywood, Mason</au><au>Edwards, Reggie</au><au>Weng, Hsin Ti</au><au>Su, Jason T.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Screening for Aortic Aneurysm After Treatment of Coarctation</atitle><jtitle>Pediatric cardiology</jtitle><stitle>Pediatr Cardiol</stitle><addtitle>Pediatr Cardiol</addtitle><date>2014</date><risdate>2014</risdate><volume>35</volume><issue>1</issue><spage>47</spage><epage>52</epage><pages>47-52</pages><issn>0172-0643</issn><eissn>1432-1971</eissn><abstract>Isolated coarctation of the aorta (CoA) occurs in 6–8 % of patients with congenital heart disease. After successful relief of obstruction, patients remain at risk for aortic aneurysm formation at the site of the repair. We sought to determine the diagnostic utility of echocardiography compared with advanced arch imaging (AAI) in diagnosing aortic aneurysms in pediatric patients after CoA repair. The Congenital Heart Databases from 1996 and 2009 were reviewed. All patients treated for CoA who had AAI defined by cardiac magnetic resonance imaging (MRI), computed tomography (CT), or catheterization were identified. Data collected included the following: type, timing, and number of interventions, presence and time to aneurysm diagnosis, and mortality. Patients were subdivided into surgical and catheterization groups for analysis. Seven hundred and fifty-nine patients underwent treatment for CoA during the study period. Three hundred and ninety-nine patients had at least one AAI. Aneurysms were diagnosed by AAI in 28 of 399 patients at a mean of 10 ± 8.4 years after treatment. Echocardiography reports were available for 380 of 399 patients with AAI. The sensitivity of echocardiography for detecting aneurysms was 24 %. The prevalence of aneurysms was significantly greater in the catheterization group (
p
< 0.05) compared with the surgery group. Aneurysm was also diagnosed earlier in the catheterization group compared with the surgery group (
p
= 0.02). Multivariate analysis showed a significantly increased risk of aneurysm diagnosis in patients in the catheterization subgroup and in patients requiring more than three procedures. Aortic aneurysms continue to be an important complication after CoA repair. Although serial echocardiograms are the test of choice for following-up most congenital cardiac lesions in pediatrics, our data show that echocardiography is inadequate for the detection of aneurysms after CoA repair. Because the time to aneurysm diagnosis was shorter and the risk greater in the catheterization group (particularly for patients requiring more than one procedure), surveillance with cardiac MRI or CT should begin earlier in these patients.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>23794012</pmid><doi>10.1007/s00246-013-0737-x</doi><tpages>6</tpages></addata></record> |
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| subjects | Adolescent Aortic Aneurysm, Thoracic - diagnosis Aortic Aneurysm, Thoracic - etiology Aortic Aneurysm, Thoracic - mortality Aortic Aneurysm, Thoracic - surgery Aortic aneurysms Aortic Coarctation - diagnosis Aortic Coarctation - epidemiology Aortic Coarctation - surgery Cardiac Catheterization - adverse effects Cardiac Catheterization - methods Cardiac Catheterization - statistics & numerical data Cardiac patients Cardiac Surgery Cardiology Catheterization Child Child, Preschool Children Comparative analysis Comparative Effectiveness Research Congenital heart disease Echocardiography - methods Echocardiography - statistics & numerical data Female Genetic disorders Health aspects Heart Heart diseases Humans Magnetic Resonance Imaging - methods Magnetic Resonance Imaging - statistics & numerical data Male Mass Screening Medicine Medicine & Public Health Mortality Original Article Postoperative Complications - diagnosis Postoperative Complications - mortality Postoperative Complications - surgery Prevalence Reoperation Retrospective Studies Risk Assessment Time-to-Treatment Tomography, X-Ray Computed - methods Tomography, X-Ray Computed - statistics & numerical data United States - epidemiology Vascular Surgery Vascular Surgical Procedures - adverse effects Vascular Surgical Procedures - methods Vascular Surgical Procedures - statistics & numerical data |
| title | Screening for Aortic Aneurysm After Treatment of Coarctation |
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