Introduction. Diagnosis of neonatal coarctation of the aorta (CoA) still
presents a challenge in routine practice because of absence of reliable
morphologic and functional parameters for early detection of this congenital
heart defect in newborns. Objective. The aim of this study is to identify
easy obtainable two-dimensional echocardiographic parameters for detection of
the CoA in newborns. Methods. Echocardiographic evaluation was performed in
30 newborns with CoA and 20 healthy neonates (control group). Measurements of
the proximal transverse arch (PTA), distal transverse arch (DTA), isthmus,
distance between the left common carotid artery (LCCA) at the origin of the
left subclavian artery (LSA), were obtained by two-dimensional
echocardiography. Aortic arch hypoplasia was defined using Mouleart, Karl and
Mee criteria, and Z-value. Index 1 was calculated as a ratio of DTA and
distance between origins LCCA-LSA, Index 2 was calculated as a ratio of the
ascending aorta and the distance between LCCA-LSA origins, and Index 3 was
calculated as a ratio of PTA and distance between LCCA-LSA origins. Results.
Index 1 was significantly lower in patients with CoA in comparison with
control group (0.50 vs. 1.39; p?0.01). A cutoff point at 0.39, for Index 1,
showed a sensitivity of 92% and specificity of 99% for the diagnosis of
neonatal CoA, while cut off points at 0.69 and 0.44, for Index 2 and Index 3,
showed the highest sensitivity and specificity for the diagnosis of CoA in
newborns. Conclusion. By using these echo indexes, two-dimensional
echocardiographic aortic arch measurement becomes a simple, reliable
noninvasive method for the evaluation of aortic coarctation in newborns and
may lead to earlier diagnosis and subsequent surgical correction.
Transverse arch hypoplasia predisposes to aneurysm formation at the repair site after patch angioplasty for coarctation of the aorta