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@PHDTHESIS{Mohammed:849724,
      author       = {Mohammed, Ahmed Farghal Ahmed},
      othercontributors = {Lebherz, Corinna and Breuer, Thomas},
      title        = {{P}roximal aortic dilatation and pulmonary valve
                      replacement in patients with repaired tetralogy of fallot:
                      {I}s there a relationship? {A} cardiac magnetic resonance
                      imaging study},
      school       = {Rheinisch-Westfälische Technische Hochschule Aachen},
      type         = {Dissertation},
      address      = {Aachen},
      reportid     = {RWTH-2022-06994},
      pages        = {19 Seiten : Illustrationen, Diagramme},
      year         = {2022},
      note         = {Dissertation, Rheinisch-Westfälische Technische Hochschule
                      Aachen, 2022},
      abstract     = {Introduction and goal setting: Aortopathy is a known
                      complication whose incidence is growing within the
                      population of tetralogy of Fallot (TOF) patients. Its
                      pathology and relationship with other comorbidities remain
                      unclear. This study was designed to determine the prevalence
                      and predictors of proximal aortic dilatation after TOF
                      repair. Materials and Methods: We retrospectively
                      investigated all patients who underwent follow-up cardiac
                      magnetic resonance imaging (CMR; at least 4 years after TOF
                      repair) between March 2004 and December 2019. The dimensions
                      at the ascending aorta (AAo) and sinus of Valsalva (SoV)
                      levels were measured. Aortic dilatation was defined as an
                      internal aortic diameter that was >2 standard deviation of
                      the previously published normal values. Results: We included
                      77 patients (mean age 28.9 ± 10.5 years, $41.5\%$ female,
                      mean follow-up of 24.5 ± 8.1 years). AAo and SoV were
                      dilated in 19 $(24.6\%)$ and 43 $(55.8\%)$ patients,
                      respectively. Patients with dilated AAo and SoV were older
                      during the corrective surgery (p < 0.001 and p = 0.004,
                      respectively) and during CMR (p = 0.002 and 0.024,
                      respectively) than patients without AAo and SoV dilatation.
                      Patients of the dilated AAo group were more likely to have
                      prior palliative shunt (p = 0.008), longer shunt duration (p
                      = 0.005), and a higher degree of aortic valve regurgitation
                      (AR) fraction (p < 0.001) and to undergo pulmonary (PVR)
                      and/or aortic valve replacement (p < 0.001 and p = 0.013,
                      respectively). PVR (p = 0.048, odds ratio = 6.413, and
                      $95\%$ CI = 1.013–40.619) and higher AR fraction (p =
                      0.031, odds ratio = 1.194, and $95\%$ CI = 1.017–1.403)
                      were independent predictors for AAo dilatation. Conclusion:
                      Aortopathy is a common progressive complication that may
                      require reintervention and lifelong follow-up. Our study
                      shows that proximal aortic dilatation may be attributed to
                      factors that increase the volume overload across the
                      proximal aorta, including late corrective surgery and
                      palliative shunt. We also found that PVR and higher AR
                      fraction are independent predictors of AAo dilatation.},
      cin          = {531010-2},
      ddc          = {610},
      cid          = {$I:(DE-82)531010-2_20140620$},
      typ          = {PUB:(DE-HGF)11},
      url          = {https://publications.rwth-aachen.de/record/849724},
}