scholarly journals Branch Pulmonary Artery Regurgitation in Repaired Tetralogy of Fallot: Correlation with Pulmonary Artery Morphology, Distensibility, and Right Ventricular Function

Tomography ◽  
2021 ◽  
Vol 7 (3) ◽  
pp. 412-423
Author(s):  
Suvipaporn Siripornpitak ◽  
Duangkanok Lueangwattanapong ◽  
Apichaya Sriprachyakul ◽  
Suthep Wanitkun ◽  
Alisa Limsuwan
Keyword(s):  
Pulmonary Artery ◽  
Right Ventricular ◽  
Ventricular Function ◽  
Tetralogy Of Fallot ◽  
Right Ventricular Function ◽  
Pulmonary Insufficiency ◽  
P Value ◽  
Strong Positive Correlation ◽  
Branch Pulmonary Artery ◽  
Repaired Tetralogy Of Fallot

Background: The aim was to determine the effect of pulmonary artery (PA) morphology on the branch pulmonary artery-regurgitation fraction (BPA-RF), the relationship of pulmonary insufficiency (PI) to BPA-RF and PA-distensibility, and factors (BPA-RF and PA-distensibility) associated with right ventricular function (RVF) in repaired tetralogy of Fallot (rTOF). Methods: A total of 182 rTOF patients (median age 17.1 years) were analyzed for length, angle of PA, BPA-RF, PI, and PA-distensibility, using magnetic resonance imaging. Results: The left PA had a significant greater RF than the right PA (median (interquartile range)): LPA 43.1% (32.6–51.5) and RPA 35.2% (24.7–44.7), p < 0.001. The LPA was shorter with a narrower angle than the RPA (p < 0.001). The anatomy of the branch-PA was not a factor for the greater LPA-RF (odds ratio, 95% confidence interval: CI, p-value): length 0.44 (0.95–2.00), p = 0.28; angle 0.63 (0.13–2.99), p = 0.56. There was a strong positive correlation between PI and BPA-RF-coefficients (95% CI), p-value: LPA 0.78% (0.70–0.86), p < 0.001; RPA 0.78% (0.71–0.84), p < 0.001 and between BPA-RF and distensibility-coefficients (95%CI), p-value: LPA 0.73% (0.37–1.09), p < 0.001; RPA 1.63% (1.22–2.03), p < 0.001, respectively. The adjusted BPA-RF did not predict RVF, RPA (p = 0.434), LPA (p = 0.268). Conclusions: PA morphology is not a significant factor for the differential BPA-RF. The vascular wall in rTOF patients responds to chronic increased intravascular volume by increasing distensibility. BPA-RF is not a determinant of RVF.

scholarly journals Right Ventricular Function Evolution With Pregnancy in Repaired Tetralogy of Fallot

2018 ◽  
Vol 34 (10) ◽  
pp. 1369.e9-1369.e11 ◽  
Author(s):  
Pamela Moceri ◽  
Maxime Sermesant ◽  
Delphine Baudouy ◽  
Emile Ferrari ◽  
Nicolas Duchateau
Keyword(s):  
Right Ventricular ◽  
Ventricular Function ◽  
Tetralogy Of Fallot ◽  
Right Ventricular Function ◽  
Repaired Tetralogy Of Fallot

Severe pulmonary valvar insufficiency should be aggressively treated

2005 ◽  
Vol 15 (S1) ◽  
pp. 64-67 ◽  
Author(s):  
Carl L. Backer
Keyword(s):  
New York ◽  
Right Ventricular ◽  
Ventricular Function ◽  
Tetralogy Of Fallot ◽  
Right Ventricular Function ◽  
Controversial Issue ◽  
Memorial Hospital ◽  
Pulmonary Insufficiency

My role in the debate between myself and Bill Gaynor is to substantiate the notion that severe pulmonary valvar insufficiency should be treated in aggressive fashion. This gives me few problems. At Children's Memorial Hospital in Chicago, we have a long tradition of favouring early insertion of new pulmonary valves in patients with significant pulmonary valvar insufficiency following repair of tetralogy of Fallot. Our results with this strategy in the current era were first presented in 1986 at the Western Thoracic Surgical Association.1 At that time, we had inserted pulmonary valves late following repair of tetralogy of Fallot in 42 patients. We postulated that early control of pulmonary insufficiency may prevent long-term deterioration in right ventricular function. The fact that this is a controversial issue became immediately apparent during the discussion of our presentation. Dr. Frank Spencer, from New York, stated “I would completely disagree with the concept of electively inserting a porcine valve in a child on the basis of haemodynamic data. I fear that the approach recommended in this presentation is probably treating one disease by creating a worse one.”

scholarly journals Evaluation of tricuspid annular plane systolic excursion measured with cardiac MRI in children with tetralogy of Fallot

2015 ◽  
Vol 26 (4) ◽  
pp. 718-724 ◽  
Author(s):  
Jonathan H. Soslow ◽  
Emem Usoro ◽  
Li Wang ◽  
David A. Parra
Keyword(s):  
Ejection Fraction ◽  
Right Ventricular ◽  
Ventricular Function ◽  
Tetralogy Of Fallot ◽  
Right Ventricular Function ◽  
Cardiac Mri ◽  
Right Ventricular Ejection Fraction ◽  
Ventricular Ejection Fraction ◽  
Repaired Tetralogy Of Fallot ◽  
Z Scores

AbstractBackgroundAneurysmal dilation of the right ventricular outflow tract complicates assessment of right ventricular function in patients with repaired tetralogy of Fallot. Tricuspid annular plane systolic excursion is commonly used to estimate ejection fraction. We hypothesised that tricuspid annular plane systolic excursion measured by cardiac MRI approximates global and segmental right ventricular function, specifically right ventricular sinus ejection fraction, in children with repaired tetralogy of Fallot.MethodsTricuspid annular plane systolic excursion was measured retrospectively on cardiac MRIs in 54 patients with repaired tetralogy of Fallot. Values were compared with right ventricular global, sinus, and infundibular ejection fractions. Tricuspid annular plane systolic excursion was indexed to body surface area, converted into a fractional value, and converted into published paediatric Z-scores.ResultsTricuspid annular plane systolic excursion measurements had good agreement between observers. Right ventricular ejection fraction did not correlate with the absolute or indexed tricuspid annular plane systolic excursion and correlated weakly with fractional tricuspid annular plane systolic excursion (r=0.41 and p=0.002). Segmental right ventricular function did not appreciably improve correlation with any of the tricuspid annular plane systolic excursion measures. Paediatric Z-scores were unable to differentiate patients with normal and abnormal right ventricular function.ConclusionsTricuspid annular plane systolic excursion measured by cardiac MRI correlates poorly with global and segmental right ventricular ejection fraction in children with repaired tetralogy of Fallot. Tricuspid annular plane systolic excursion is an unreliable approximation of right ventricular function in this patient population.

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