Dimensions of the Ascending Aorta in Conotruncal Heart Defects

Dilatation of the ascending aorta is an important sequel in conotruncal anomalies, such as tetralogy of Fallot (TOF) or d-transposition of the great arteries (TGA). We measured dimensions and their progression at different levels of the ascending aorta in 80 patients. In TOF patients, mean z -score for aortic annulus was 1.65 (range −3.16–6.47), for sinus 1.93 (range −2.28–5.39), for st-junction 4.15 (range 0.0–8.18), and for ascending aorta 3.51 (range −1.23–6.36). Over time, annulus z -scores increased in the univariate analysis [0.07/year, 95 % confidence interval (CI) 0.01–0.14; p = 0.02], and this was unique to male patients (0.08/year, 95 % CI 0.00–0.15; p = 0.05). z -scores of the ascending aorta decreased (−0.1/year, 95 % CI −0.18 to −0.02; p = 0.02), and this was confined to patients without aortic regurgitation (AR; −0.09/year, 95 % CI −0.18 to −0.01; p = 0.04). In TGA, mean z -score for the aortic annulus was 2.13 (range −3.71–8.39), for sinus 1.77 (range −3.04–6.69), for st-junction 1.01 (range −5.44–6.71), and for ascending aorta 0.82 (range −4.91–6.46). In bivariate analysis, annulus z -scores decreased in females (−0.14/year, 95 % CI −0.25 to −0.03; p = 0.01) and in patients without AR (−0.07/year, 95 % CI −0.14–0.0; p = 0.03). z -scores of the ascending aorta increased significantly in males (0.08/year, 95 % CI 0.0 to 0.16; p = 0.05) and in patients with AR (0.12/year, 95 % CI 0.03–0.21; p = 0.01). In conclusion, TOF and TGA z -scores of the ascending aorta differ significantly from those of the normal population. Progression of z -scores over time is influenced by diagnosis, sex, and presence of AR.