{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T21:12:52Z","timestamp":1789765972936,"version":"4.0.1"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2013,1,15]]},"abstract":"<jats:sec>\n                    <jats:title>Background\u2014<\/jats:title>\n                    <jats:p>Although aortic root pathology has been described in patients with tetralogy of Fallot, the scope of the problem remains poorly defined. We sought to determine the prevalence and predictors of aortic root dilatation in adults with repaired tetralogy of Fallot.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results\u2014<\/jats:title>\n                    <jats:p>\n                      A multicenter cross-sectional study was conducted with standardized reassessment of echocardiographic parameters in 474 adults (\u226518 years) with surgically repaired tetralogy of Fallot or pulmonary atresia with ventricular septal defect. The aortic root was measured in a parasternal long-axis view, in diastole, at the level of the sinus of Valsalva. Prevalence and predictors of an absolute diameter \u226540 mm and of an observed-to-expected ratio &gt;1.5 were assessed. The aortic root dimension was \u226540 mm in 28.9% (95% confidence interval, 26.9%\u201330.9%). In multivariate analyses, the only independently associated factor was male sex (odds ratio, 4.48; 95% confidence interval, 1.55\u201312.89;\n                      <jats:italic>P<\/jats:italic>\n                      =0.006). The prevalence of an observed-to-expected aortic root dimension ratio &gt;1.5 was 6.6% (95% confidence interval, 5.3%\u20137.9%). It was associated with pulmonary atresia and moderate or severe aortic regurgitation in univariate analyses, but no independent predictor was identified. The side of the aortic arch was not associated with aortic root dimension. The prevalence of moderate or severe aortic regurgitation was 3.5% (95% confidence interval, 2.7%\u20134.2%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions\u2014<\/jats:title>\n                    <jats:p>Although nearly one third of adults with repaired tetralogy of Fallot have an aortic root diameter \u226540 mm, the prevalence of a dilated aortic root, when defined by an indexed ratio of observed-to-expected values, is low. Similarly, moderate or severe aortic regurgitation is uncommon.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circulationaha.112.129585","type":"journal-article","created":{"date-parts":[[2012,12,7]],"date-time":"2012-12-07T02:01:25Z","timestamp":1354845685000},"page":"172-179","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":114,"title":["Aortic Root Dilatation in Adults with Surgically Repaired Tetralogy of Fallot"],"prefix":"10.1161","volume":"127","author":[{"given":"Fran\u00e7ois-Pierre","family":"Mongeon","sequence":"first","affiliation":[{"name":"From the Adult Congenital Heart Center, Montreal Heart Institute, Universit\u00e9 de Montr\u00e9al, Montreal, Quebec (F.-P.M., P.K.); Boston Adult Congenital Heart Service, Children\u2019s Hospital Boston and Brigham and Women\u2019s Hospital, Boston, MA (M.Z.G., A.R.O., A.M.V., M.J.L., P.K.); Oregon Health and Science University, Portland, OR (C.S.B.); Ahmanson\/UCLA Adult Congenital Heart Disease Center, Los Angeles, CA (J.A.); University of Colorado, Denver, CO (J.D.K.); Medical College of Wisconsin, Milwaukee, WI (M..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle Z.","family":"Gurvitz","sequence":"additional","affiliation":[{"name":"From the Adult Congenital Heart Center, Montreal Heart Institute, Universit\u00e9 de Montr\u00e9al, Montreal, Quebec (F.-P.M., P.K.); Boston Adult Congenital Heart Service, Children\u2019s Hospital Boston and Brigham and Women\u2019s Hospital, Boston, MA (M.Z.G., A.R.O., A.M.V., M.J.L., P.K.); Oregon Health and Science University, Portland, OR (C.S.B.); Ahmanson\/UCLA Adult Congenital Heart Disease Center, Los Angeles, CA (J.A.); University of Colorado, Denver, CO (J.D.K.); Medical College of Wisconsin, Milwaukee, WI (M..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig S.","family":"Broberg","sequence":"additional","affiliation":[{"name":"From the Adult Congenital Heart Center, Montreal Heart Institute, Universit\u00e9 de Montr\u00e9al, Montreal, Quebec (F.-P.M., P.K.); Boston Adult Congenital Heart Service, Children\u2019s Hospital Boston and Brigham and Women\u2019s Hospital, Boston, MA (M.Z.G., A.R.O., A.M.V., M.J.L., P.K.); Oregon Health and Science University, Portland, OR (C.S.B.); Ahmanson\/UCLA Adult Congenital Heart Disease Center, Los Angeles, CA (J.A.); University of Colorado, Denver, CO (J.D.K.); Medical College of Wisconsin, Milwaukee, WI (M..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamil","family":"Aboulhosn","sequence":"additional","affiliation":[{"name":"From the Adult Congenital Heart Center, Montreal Heart Institute, Universit\u00e9 de Montr\u00e9al, Montreal, Quebec (F.-P.M., P.K.); Boston Adult Congenital Heart Service, Children\u2019s Hospital Boston and Brigham and Women\u2019s Hospital, Boston, MA (M.Z.G., A.R.O., A.M.V., M.J.L., P.K.); Oregon Health and Science University, Portland, OR (C.S.B.); Ahmanson\/UCLA Adult Congenital Heart Disease Center, Los Angeles, CA (J.A.); University of Colorado, Denver, CO (J.D.K.); Medical College of Wisconsin, Milwaukee, WI (M..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander R.","family":"Opotowsky","sequence":"additional","affiliation":[{"name":"From the Adult Congenital Heart Center, Montreal Heart Institute, Universit\u00e9 de Montr\u00e9al, Montreal, Quebec (F.-P.M., P.K.); Boston Adult Congenital Heart Service, Children\u2019s Hospital Boston and Brigham and Women\u2019s Hospital, Boston, MA (M.Z.G., A.R.O., A.M.V., M.J.L., P.K.); Oregon Health and Science University, Portland, OR (C.S.B.); Ahmanson\/UCLA Adult Congenital Heart Disease Center, Los Angeles, CA (J.A.); University of Colorado, Denver, CO (J.D.K.); Medical College of Wisconsin, Milwaukee, WI (M..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph D.","family":"Kay","sequence":"additional","affiliation":[{"name":"From the Adult Congenital Heart Center, Montreal Heart Institute, Universit\u00e9 de Montr\u00e9al, Montreal, Quebec (F.-P.M., P.K.); Boston Adult Congenital Heart Service, Children\u2019s Hospital Boston and Brigham and Women\u2019s Hospital, Boston, MA (M.Z.G., A.R.O., A.M.V., M.J.L., P.K.); Oregon Health and Science University, Portland, OR (C.S.B.); Ahmanson\/UCLA Adult Congenital Heart Disease Center, Los Angeles, CA (J.A.); University of Colorado, Denver, CO (J.D.K.); Medical College of Wisconsin, Milwaukee, WI (M..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne Marie","family":"Valente","sequence":"additional","affiliation":[{"name":"From the Adult Congenital Heart Center, Montreal Heart Institute, Universit\u00e9 de Montr\u00e9al, Montreal, Quebec (F.-P.M., P.K.); Boston Adult Congenital Heart Service, Children\u2019s Hospital Boston and Brigham and Women\u2019s Hospital, Boston, MA (M.Z.G., A.R.O., A.M.V., M.J.L., P.K.); Oregon Health and Science University, Portland, OR (C.S.B.); Ahmanson\/UCLA Adult Congenital Heart Disease Center, Los Angeles, CA (J.A.); University of Colorado, Denver, CO (J.D.K.); Medical College of Wisconsin, Milwaukee, WI (M..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael G.","family":"Earing","sequence":"additional","affiliation":[{"name":"From the Adult Congenital Heart Center, Montreal Heart Institute, Universit\u00e9 de Montr\u00e9al, Montreal, Quebec (F.-P.M., P.K.); Boston Adult Congenital Heart Service, Children\u2019s Hospital Boston and Brigham and Women\u2019s Hospital, Boston, MA (M.Z.G., A.R.O., A.M.V., M.J.L., P.K.); Oregon Health and Science University, Portland, OR (C.S.B.); Ahmanson\/UCLA Adult Congenital Heart Disease Center, Los Angeles, CA (J.A.); University of Colorado, Denver, CO (J.D.K.); Medical College of Wisconsin, Milwaukee, WI (M..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George K.","family":"Lui","sequence":"additional","affiliation":[{"name":"From the Adult Congenital Heart Center, Montreal Heart Institute, Universit\u00e9 de Montr\u00e9al, Montreal, Quebec (F.-P.M., P.K.); Boston Adult Congenital Heart Service, Children\u2019s Hospital Boston and Brigham and Women\u2019s Hospital, Boston, MA (M.Z.G., A.R.O., A.M.V., M.J.L., P.K.); Oregon Health and Science University, Portland, OR (C.S.B.); Ahmanson\/UCLA Adult Congenital Heart Disease Center, Los Angeles, CA (J.A.); University of Colorado, Denver, CO (J.D.K.); Medical College of Wisconsin, Milwaukee, WI (M..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan M.","family":"Fernandes","sequence":"additional","affiliation":[{"name":"From the Adult Congenital Heart Center, Montreal Heart Institute, Universit\u00e9 de Montr\u00e9al, Montreal, Quebec (F.-P.M., P.K.); Boston Adult Congenital Heart Service, Children\u2019s Hospital Boston and Brigham and Women\u2019s Hospital, Boston, MA (M.Z.G., A.R.O., A.M.V., M.J.L., P.K.); Oregon Health and Science University, Portland, OR (C.S.B.); Ahmanson\/UCLA Adult Congenital Heart Disease Center, Los Angeles, CA (J.A.); University of Colorado, Denver, CO (J.D.K.); Medical College of Wisconsin, Milwaukee, WI (M..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah R.","family":"Gersony","sequence":"additional","affiliation":[{"name":"From the Adult Congenital Heart Center, Montreal Heart Institute, Universit\u00e9 de Montr\u00e9al, Montreal, Quebec (F.-P.M., P.K.); Boston Adult Congenital Heart Service, Children\u2019s Hospital Boston and Brigham and Women\u2019s Hospital, Boston, MA (M.Z.G., A.R.O., A.M.V., M.J.L., P.K.); Oregon Health and Science University, Portland, OR (C.S.B.); Ahmanson\/UCLA Adult Congenital Heart Disease Center, Los Angeles, CA (J.A.); University of Colorado, Denver, CO (J.D.K.); Medical College of Wisconsin, Milwaukee, WI (M..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen C.","family":"Cook","sequence":"additional","affiliation":[{"name":"From the Adult Congenital Heart Center, Montreal Heart Institute, Universit\u00e9 de Montr\u00e9al, Montreal, Quebec (F.-P.M., P.K.); Boston Adult Congenital Heart Service, Children\u2019s Hospital Boston and Brigham and Women\u2019s Hospital, Boston, MA (M.Z.G., A.R.O., A.M.V., M.J.L., P.K.); Oregon Health and Science University, Portland, OR (C.S.B.); Ahmanson\/UCLA Adult Congenital Heart Disease Center, Los Angeles, CA (J.A.); University of Colorado, Denver, CO (J.D.K.); Medical College of Wisconsin, Milwaukee, WI (M..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer Grando","family":"Ting","sequence":"additional","affiliation":[{"name":"From the Adult Congenital Heart Center, Montreal Heart Institute, Universit\u00e9 de Montr\u00e9al, Montreal, Quebec (F.-P.M., P.K.); Boston Adult Congenital Heart Service, Children\u2019s Hospital Boston and Brigham and Women\u2019s Hospital, Boston, MA (M.Z.G., A.R.O., A.M.V., M.J.L., P.K.); Oregon Health and Science University, Portland, OR (C.S.B.); Ahmanson\/UCLA Adult Congenital Heart Disease Center, Los Angeles, CA (J.A.); University of Colorado, Denver, CO (J.D.K.); Medical College of Wisconsin, Milwaukee, WI (M..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle J.","family":"Nickolaus","sequence":"additional","affiliation":[{"name":"From the Adult Congenital Heart Center, Montreal Heart Institute, Universit\u00e9 de Montr\u00e9al, Montreal, Quebec (F.-P.M., P.K.); Boston Adult Congenital Heart Service, Children\u2019s Hospital Boston and Brigham and Women\u2019s Hospital, Boston, MA (M.Z.G., A.R.O., A.M.V., M.J.L., P.K.); Oregon Health and Science University, Portland, OR (C.S.B.); Ahmanson\/UCLA Adult Congenital Heart Disease Center, Los Angeles, CA (J.A.); University of Colorado, Denver, CO (J.D.K.); Medical College of Wisconsin, Milwaukee, WI (M..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Landzberg","sequence":"additional","affiliation":[{"name":"From the Adult Congenital Heart Center, Montreal Heart Institute, Universit\u00e9 de Montr\u00e9al, Montreal, Quebec (F.-P.M., P.K.); Boston Adult Congenital Heart Service, Children\u2019s Hospital Boston and Brigham and Women\u2019s Hospital, Boston, MA (M.Z.G., A.R.O., A.M.V., M.J.L., P.K.); Oregon Health and Science University, Portland, OR (C.S.B.); Ahmanson\/UCLA Adult Congenital Heart Disease Center, Los Angeles, CA (J.A.); University of Colorado, Denver, CO (J.D.K.); Medical College of Wisconsin, Milwaukee, WI (M..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Khairy","sequence":"additional","affiliation":[{"name":"From the Adult Congenital Heart Center, Montreal Heart Institute, Universit\u00e9 de Montr\u00e9al, Montreal, Quebec (F.-P.M., P.K.); Boston Adult Congenital Heart Service, Children\u2019s Hospital Boston and Brigham and Women\u2019s Hospital, Boston, MA (M.Z.G., A.R.O., A.M.V., M.J.L., P.K.); Oregon Health and Science University, Portland, OR (C.S.B.); Ahmanson\/UCLA Adult Congenital Heart Disease Center, Los Angeles, CA (J.A.); University of Colorado, Denver, CO (J.D.K.); Medical College of Wisconsin, Milwaukee, WI (M..."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.2008.01152.x"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-003-0665-2"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2007.06.011"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.105.537928"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000028462.88597.ad"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2005.09.141"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2004.07.002"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(97)70232-0"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2004.03.026"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2004.05.037"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2010.06.045"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2008.03.014"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.109.928481"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2010.12.026"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0894-7317(03)00335-3"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(89)90430-X"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2010.08.052"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e3181d4739e"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2006.05.021"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.280.22.1926"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(01)03236-2"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.702720"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1161\/circimaging.108.768911"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-0004.2011.01646.x"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1067\/mtc.2002.122310"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.740878"},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(89)90338-X"},{"key":"e_1_3_4_29_2","first-page":"888","volume-title":"Moss and Adams\u2019 Heart Disease in Infants, Children, and Adolescents Including the Fetus and the Young Adult","author":"Siwik ES","year":"2008","unstructured":"Siwik ES, Erenberg F, Zahka KG. , Allen HD, Driscoll D, Shaddy RE, Feltes TF Tetralogy of Fallot. In: Moss and Adams\u2019 Heart Disease in Infants, Children, and Adolescents Including the Fetus and the Young Adult. 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