All measurements were indexed for body surface area BSA [ 7 ]. Aortic stenosis was diagnosed from Doppler tracings, and classified as mild mean gradient below 25 mm Hgmoderate mean gradient 25 to 40 mm Hg or severe mean gradient above 40 mm Hg [ 18 ]. Systematic analysis was performed using dedicated software Systematic Software Engineering, Aarhus, Denmarkallowing reconstruction of the 3D stack of data in any plane Figure 1 [ 614 ]. Consequently, risk stratification for aortic dissection in TS should not solely be based on cross-sectional aortic diameter and the presence of fixed risk factors BAV, hypertension, aortic coarctation and karyotype ; it should also include assessment of changes in aortic diameter in TS to provide a more nuanced prognostication. Google Scholar
BACKGROUND: The risk for. Pediatric patients with dissection have known CHD, but adults often have aortic valve and arch abnormalities detected only by screening cardiac MR (CMR). Aortic dilatation and dissection in Turner syndrome.
Aorta, Thoracic/pathology; Aortic Aneurysm/epidemiology; Aortic Aneurysm/etiology*.
An extended follow-up period could have revealed further associations between aortic growth and other risk markers of dissection beyond aortic valve morphology, which might include hypertension, karyotype 45,X or aortic coarctation. By use of this modality we aimed to study aortic growth, as it is an important surrogate marker for aortic dissection that adds prognostic information to cross-sectionally assessed aortic diameter [ 16 ].
Transthoracic echocardiography and hour ambulatory blood pressure were also performed. Statistical computations were performed using SPSS Article PubMed Google Scholar 6. Clin Endocrinol Oxf.
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|Ambulatory blood pressures were recorded over hours with oscillometric measurements every 20 minutes SpaceLabsWashington, USA.
Aortic dilation was defined as a diameter exceeding two standard deviations above the mean of the control group. Google Scholar All participants gave informed consented.
Here, the positioning of the measurement plane Plane A is schematically demonstrated for the aortic sinus in a patient with Turner syndrome and tricuspid aortic valve morphology. No autopsies were performed.
It is unknown whether aortic dilatation precedes acute aortic dissection in TS and, i Pseudocoarctation of the aortic arch in a patient with Turner's syndrome.
The risk of aortic dissection is fold increased in Turner The bicuspid aortic valve conferred higher aortic sinus growth rates (p < ).
Multiplane reformatting was used to map diameters of the aorta in a measurement plane that was perpendicular to the direction of blood flow and orthogonal to the aortic wall at the position of measurement. Aortic dimensions were measured at nine predefined positions using 3D, non-contrast and free-breathing cardiovascular magnetic resonance.
Our stance corresponds well with recent guidelines for diagnosis and monitoring of thoracic aortic disease, where TTE was deemed problematic for serial assessment of aortic calibre when pathology extends beyond the sinotubular junction [ 16 ]. Download citation. Systematic analysis was performed using dedicated software Systematic Software Engineering, Aarhus, Denmarkallowing reconstruction of the 3D stack of data in any plane Figure 1 [ 614 ].
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|No cardiovascular events occurred during follow-up in patients who completed the study or withdrew their consent.
Methods Eighty adult TS patients were examined twice with a mean follow-up of 2. No other aortic measurement position was found to have similar associations with BAV.
Stat Methods Med Res. The issue of initiation and choice of medical prophylaxis through antihypertensive treatment also remains unresolved in TS [ 3 ]. J Am Coll Cardiol.
Aortic Dissection in Turner Syndrome
It is unknown whether aortic dilatation precedes acute aortic dissection in TS and. Increased prevalence of bicuspid aortic valve in Turner syndrome links with.
Aortic dissection and rupture in Turner syndrome. 8 2 1. Number 5. Fig. 1. Two dimensional echocardiographic image (patient 1) showing dilated aortic root.
Aortic dilatation and dissection in Turner syndrome.
The positions were: i aortic sinuses measuring cusp-to-opposing-cusp diameter at the point of the maximum aortic diameter in the aortic sinus [Figure 3 ]ii ascending aorta at the sinotubular junction; iii mid-ascending aorta at the level of the inferior margin of right pulmonary artery; iv distal ascending aorta immediately proximal to brachiocephalic artery; v proximal aortic arch between the brachiocephalic and left carotid artery arteries; vi distal aortic arch immediately proximal to left subclavian artery; vii aortic isthmus immediately distal to the left subclavian artery; viii proximal descending aorta between the left pulmonary artery and the top of left atrium: and: ix distal descending aorta at the most caudal border of the left atrium.
Methods Eighty adult TS patients were examined twice with a mean follow-up of 2.
Aortic valve morphology and function were assessed. However, these risk markers are not identified in all aortic dissections in TS [ 45 ] and aortic follow-up is therefore recommended for all patients [ 8 ].
Video: Turners and aortic root dissection Aortic Aneurysm and Dissection