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J Am Coll Cardiol, 2007; 49:883-890, doi:10.1016/j.jacc.2006.10.057 (Published online 8 February 2007).
© 2007 by the American College of Cardiology Foundation
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Vascular Remodeling After "Successful" Repair of Coarctation

Impact of Aortic Arch Geometry

Phalla Ou, MD*,{dagger},*, David S. Celermajer, MBBS, DSc, FRACP{ddagger}, Elie Mousseaux, MD, PhD{dagger},§, Alain Giron, PhD{dagger}, Yacine Aggoun, MD||, Isabelle Szezepanski||, Daniel Sidi, MD, PhD|| and Damien Bonnet, MD, PhD||,¶

* Department of Pediatric Radiology, University Rene Descartes-Paris V, Hôpital Necker-Enfants Malades, AP-HP, Paris, France
{dagger} INSERM UMR-S678, Faculté de Médecine Pitié Salpétrière, Paris, France
{ddagger} Department of Medicine, University of Sydney, Sydney, Australia
§ Department of Cardiovascular Radiology, University Rene Descartes-Paris V, Hôpital Européen Georges Pompidou, AP-HP, Paris, France
|| Department of Pediatric Cardiology, University Rene Descartes-Paris V, Hôpital Necker-Enfants Malades, AP-HP, Paris, France
INSERM EMI-U 0016, University Rene Descartes-Paris V, Paris, France.


Figure 1
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  		Figure 1 Aortic Arch Measurements

Aortic arch width (W) corresponds to the transverse diameter of the arch and is defined as the maximal transverse distance between the midpoints of the ascending and descending aorta, close to the axial plane going through the right pulmonary artery. Height of the aortic arch (H) is defined as the maximal vertical distance between W and the highest mid-point of the aortic arch. {Phi}m is the minimal diameter at the coarctectomy site, and {Phi}D is the diameter of the descending aorta.

 

Figure 2
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  		Figure 2 Three Different Morphologies of the Aortic Arch After Coarctation Repair

From left to right: Gothic geometry, Crenel, and Romanesque (see definitions in the text).

 

Figure 3
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  		Figure 3 Vascular Parameters in the Different Subtypes of Aortic Arch Geometry and in Control Subjects

Einc = incremental elastic modulus of elasticity; FMD = flow-mediated dilation; GTN = glyceryltrinitate; IMT = intima-media thickness.

 

Figure 4
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  		Figure 4 Correlations Between Vascular Parameters and H/W

H/W = height/width ratio; other abbreviations as in Figure 3.

 




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