Comparative Measurements of Aortic Diameters Using Transthoracic Echocardiography and Thoracic Computed Tomography Angiography in Neonatal Aortic Coarctation

Abstract Background: Critical aortic coarctation is defined as the severe narrowing of the isthmic aortic lumen, representing a neonatal cardiac emergency, part of the congenital heart diseases with duct-dependent systemic circulation. Aim of the study: To assess the correlation between transthoracic echocardiography and computed tomography angiography (CTA) in the measurement of aortic diameters in a group of newborns diagnosed with duct-dependent aortic coarctation and/or associated hypoplastic aortic arch. Material and method: We performed a retrospective study on neonates diagnosed with duct-dependent aortic coarctation and/or associated hypoplastic aortic arch between January 1, 2015 and March 1, 2017. The studied parameters were diameters of the aorta at the level of the aortic annulus, coronary sinuses, sinotubular junction, ascending aorta, proximal and distal aortic arch, and the aortic isthmus. Measurements were obtained by transthoracic echocardiography and thoracic CTA. Results: Fifteen newborns diagnosed with duct-dependent aortic coarctation and/or associated hypoplastic aortic arch were included in this study. There was no statistically significant difference between the two imaging methods, the T test highlighting differences only between the measurements of the aortic annulus (p <0.016) and coronary sinuses (p <0.008). The patients included in the study associated other cardiovascular abnormalities: persistent ductus arteriosus (100%), atrial septal defect (100%), aortic arch hypoplasia (80%), bicuspid aortic valve (73.3%). Conclusions: These methods reveal important information on the anatomy of the cardiovascular malformation and its impact on the clinical and paraclinical status of the patient, being fundamental for establishing an optimal therapeutic approach.

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Mind the Heart: Electrocardiography-gated cardiac computed tomography-angiography in acute ischaemic stroke—rationale and study design

European Stroke Journal ◽

10.1177/2396987320962911 ◽

2020 ◽

Vol 5 (4) ◽

pp. 441-448

Author(s):

Valeria Guglielmi ◽

Leon A Rinkel ◽

Nina-Suzanne Groeneveld ◽

Nick HJ Lobé ◽

S Matthijs Boekholdt ◽

...

Keyword(s):

Computed Tomography ◽

Ischaemic Stroke ◽

Aortic Arch ◽

Acute Phase ◽

Acute Ischaemic Stroke ◽

Computed Tomography Angiography ◽

Transthoracic Echocardiography ◽

Diagnostic Yield ◽

Cardiac Computed Tomography ◽

Cardiac Computed Tomography Angiography

Rationale About one-third of ischaemic strokes are caused by cardioembolism, and a substantial proportion of cryptogenic strokes likely also originate from the heart or aortic arch. Early determination of aetiology is important to optimise management. Computed Tomography-angiography of the heart is emerging as an alternative to echocardiography to detect cardio-aortic sources of embolism in stroke patients, but its diagnostic yield in acute ischaemic stroke has not been thoroughly assessed. Hypothesis: We hypothesise that electrocardiography-gated computed tomography-angiography of the heart and aortic arch, acquired in the acute phase in patients with ischaemic stroke, has a higher diagnostic yield than transthoracic echocardiography as a first-line screening method for detection of cardio-aortic sources of embolism. Methods and design Mind the Heart is a single-centre prospective observational cohort study. We will include consecutive adult patients with acute ischaemic stroke who are potentially eligible for reperfusion therapy. Patients undergo non-electrocardiography-gated computed tomography-angiography of the aortic arch, cervical and intracranial arteries, directly followed by prospective sequential electrocardiography-gated cardiac computed tomography-angiography. Routine work-up for cardioembolism including 12-leads electrocardiography, Holter electrocardiography and transthoracic echocardiography is performed as soon as possible. The primary endpoint is the proportion of patients with a predefined high-risk cardio-aortic source of embolism on computed tomography-angiography versus transthoracic echocardiography in patients who underwent both investigations. Based on an expected 5% additional yield of computed tomography-angiography, a sample size of 450 patients is required. Conclusions The Mind the Heart study will generate a reliable estimate of the diagnostic yield of echocardiography-gated cardio-aortic computed tomography-angiography performed in the acute phase of ischaemic stroke.

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Circumflex retroesophageal left aortic arch with right ductus arteriosus: A rare complete vascular ring diagnosed on computed tomography angiography

Annals of Pediatric Cardiology ◽

10.4103/apc.apc_128_19 ◽

2020 ◽

Vol 13 (1) ◽

pp. 98

Author(s):

GurpreetSingh Gulati ◽

NirajNirmal Pandey ◽

Manish Shaw ◽

Sakshi Sachdeva ◽

ShyamS Kothari

Keyword(s):

Computed Tomography ◽

Aortic Arch ◽

Computed Tomography Angiography ◽

Ductus Arteriosus ◽

Vascular Ring ◽

Right Ductus Arteriosus

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Computed tomography angiography and microsurgical flaps for traumatic wounds: What is the added value?

Clinical Hemorheology and Microcirculation ◽

10.3233/ch-200986 ◽

2021 ◽

pp. 1-9

Author(s):

Lucas Sousa Macedo ◽

Renato Polese Rusig ◽

Gustavo Bersani Silva ◽

Alvaro Baik Cho ◽

Teng Hsiang Wei ◽

...

Keyword(s):

Computed Tomography ◽

Upper Limb ◽

Computed Tomography Angiography ◽

Lower Limb ◽

High Energy ◽

Lower Limbs ◽

Added Value ◽

Vascular Lesions ◽

Limb Injuries ◽

Significant Difference

BACKGROUND: Microsurgical flaps are widely used to treat complex traumatic wounds of upper and lower limbs. Few studies have evaluated whether the vascular changes in preoperative computed tomography angiography (CTA) influence the selection of recipient vessel and type of anastomosis and the microsurgical flaps outcomes including complications. OBJECTIVE: The aim of this study was to evaluate if preoperative CTA reduces the occurrence of major complications (revision of the anastomosis, partial or total flap failure, and amputation) of the flaps in upper and lower limb trauma, and to describe and analyze the vascular lesions of the group with CTA and its relationship with complications. METHODS: A retrospective cohort study was undertaken with all 121 consecutive patients submitted to microsurgical flaps for traumatic lower and upper limb, from 2014 to 2020. Patients were divided into two groups: patients with preoperative CTA (CTA+) and patients not submitted to CTA (CTA–). The presence of postoperative complications was assessed and, within CTA+, we also analyzed the number of patent arteries on CTA and described the arterial lesions. RESULTS: Of the 121 flaps evaluated (84 in the lower limb and 37 in the upper limb), 64 patients underwent preoperative CTA. In the CTA+ group, 56% of patients with free flaps for lower limb had complete occlusion of one artery. CTA+ patients had a higher rate of complications (p = 0.031), which may represent a selection bias as the most complex limb injuries and may have CTA indicated more frequently. The highest rate of complications was observed in chronic cases (p = 0.034). There was no statistically significant difference in complications in patients with preoperative vascular injury or the number of patent arteries. CONCLUSIONS: CTA should not be performed routinely, however, CTA may help in surgical planning, especially in complex cases of high-energy and chronic cases, since it provides information on the best recipient artery and the adequate level to perform the microanastomosis, outside the lesion area.

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Computed tomography angiography of hybrid thoracic endovascular aortic repair of the aortic arch

Expert Review of Cardiovascular Therapy ◽

10.1586/erc.13.47 ◽

2013 ◽

Vol 11 (5) ◽

pp. 589-606 ◽

Cited By ~ 2

Author(s):

Nila J Akhtar ◽

Gustavo S Oderich ◽

Terri J Vrtiska ◽

Eric E Williamson ◽

Philip A Araoz

Keyword(s):

Computed Tomography ◽

Aortic Arch ◽

Computed Tomography Angiography ◽

Thoracic Endovascular Aortic Repair ◽

Endovascular Aortic Repair ◽

Aortic Repair

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Measurement of Lingual Artery Using Ultrasound Versus Computed Tomography Angiography for Midline Glossectomy in Patients With Obstructive Sleep Apnea

Annals of Otology Rhinology & Laryngology ◽

10.1177/00034894211062697 ◽

2021 ◽

pp. 000348942110626

Author(s):

Chenhai Zheng ◽

Lei Shi ◽

Dengxiang Xing ◽

Jie Qin ◽

Peipei Ji ◽

...

Keyword(s):

Computed Tomography ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Computed Tomography Angiography ◽

Lingual Artery ◽

Obstructive Sleep ◽

Significant Difference

Objective: To clarify the differences in assessing the course of the lingual artery between lingual artery computed tomography angiography (CTA) and ultrasound (US). Methods: Twenty-six OSA patients were included in this study and accomplished lingual artery CTA and US, respectively. The differences in the depths of the lingual arteries and the distances between the bilateral lingual arteries on 3 measurement levels based on lingual artery CTA and US were compared. Results: The depths of the lingual arteries on 3 measurement levels by CTA were deeper than those by US ( P < .01). There was no significant difference in the distances between bilateral lingual arteries on 3 measurement levels between CTA and US ( P > .05). Conclusions: The parameters of lingual artery measured by lingual artery US were similar to or smaller than those measured by lingual artery CTA. Like lingual artery CTA, lingual artery US could be used as an effective method to ensure the safety of the operation.

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Aortic coarctation with hypoplastic aortic arch

Journal of Thoracic and Cardiovascular Surgery ◽

10.1016/s0022-5223(19)35208-0 ◽

1988 ◽

Vol 96 (4) ◽

pp. 557-563 ◽

Cited By ~ 89

Author(s):

Pascal R. Vouhé ◽

Françoise Trinquet ◽

Yves Lecompte ◽

Françoise Vernant ◽

Pierre-Michel Roux ◽

...

Keyword(s):

Aortic Arch ◽

Aortic Coarctation ◽

Hypoplastic Aortic Arch

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Hypoplastic aortic arch with aortic coarctation: Surgical correction

Journal of Thoracic and Cardiovascular Surgery ◽

10.1016/s0022-5223(19)38800-2 ◽

1985 ◽

Vol 89 (3) ◽

pp. 465-468 ◽

Cited By ~ 15

Author(s):

J.G. Vincent ◽

O. Daniels ◽

A. van Oort ◽

L.K. Lacquet

Keyword(s):

Aortic Arch ◽

Aortic Coarctation ◽

Surgical Correction ◽

Hypoplastic Aortic Arch

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Anatomic Suitability for Branched Thoracic Endovascular Repair in Patients with Aortic Arch Pathological Features

Journal of the American Heart Association ◽

10.1161/jaha.120.016695 ◽

2020 ◽

Vol 9 (20) ◽

Author(s):

Stefan P.M. Smorenburg ◽

Matthew Montesano ◽

Tijs J. Hoogteijling ◽

Maarten Truijers ◽

Petr Symersky ◽

...

Keyword(s):

Computed Tomography ◽

Aortic Arch ◽

Endovascular Repair ◽

Computed Tomography Angiography ◽

Open Surgery ◽

High Volume ◽

Pathological Features ◽

Type B ◽

Thoracic Endovascular Repair ◽

Thoracic Aneurysms

Background Endovascular repair has become a viable alternative for aortic pathological features, including those located within the aortic arch. We investigated the anatomic suitability for branched thoracic endovascular repair in patients previously treated with conventional open surgery for aortic arch pathological features. Methods and Results Patients who underwent open surgery for aortic arch pathological features at our institution between 2000 and 2018 were included. Anatomic suitability was determined by strict compliance with the anatomic criteria within manufacturers’ instructions for use for each of the following branched thoracic stent grafts: Relay Plus Double‐Branched (Terumo‐Aortic), TAG Thoracic Branch Endoprosthesis (W.L. Gore & Associates), Zenith Arch Branched Device (Cook‐Medical), and Nexus Stent Graft System (Endospan Ltd/Jotec GmbH). Computed tomography angiography images were analyzed with outer luminal line measurements. A total of 377 patients (mean age, 64±14 years; 64% men) were identified, 153 of whom had suitable computed tomography angiography images for measurements. In total, 59 patients (15.6% of the total cohort and 38.6% of the measured cohort) were eligible for endovascular repair using at least one of the devices. Device suitability was 30.9% for thoracic aneurysms, 4.6% for type A dissections, 62.5% for type B dissections, and 28.6% for other pathological features. Conclusions The anatomic suitability for endovascular repair of all aortic arch pathological features was modest. The highest suitability rates were observed for thoracic aneurysms and for type B dissections, of which repair included part of the aortic arch. We suggest endovascular repair of arch pathological features should be reserved for high‐volume centers with experience in endovascular arch repair.

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