scholarly journals Patient-Specific MRI-Based 3D FSI RV/LV/Patch Models for Pulmonary Valve Replacement Surgery and Patch Optimization

2008 ◽  
Vol 130 (4) ◽  
Author(s):  
Dalin Tang ◽  
Chun Yang ◽  
Tal Geva ◽  
Pedro J. del Nido
Keyword(s):  
Valve Replacement ◽  
Pulmonary Valve ◽  
Scar Tissue ◽  
Mechanical Analysis ◽  
Pulmonary Valve Replacement ◽  
Patient Specific ◽  
Fluid Structure Interactions ◽  
Replacement Surgery ◽  
Cardiac Functions ◽  
Before And After

A patient-specific right/left ventricle and patch (RV/LV/patch) combination model with fluid-structure interactions (FSIs) was introduced to evaluate and optimize human pulmonary valve replacement/insertion (PVR) surgical procedure and patch design. Cardiac magnetic resonance (CMR) imaging studies were performed to acquire ventricle geometry, flow velocity, and flow rate for healthy volunteers and patients needing RV remodeling and PVR before and after scheduled surgeries. CMR-based RV/LV/patch FSI models were constructed to perform mechanical analysis and assess RV cardiac functions. Both pre- and postoperation CMR data were used to adjust and validate the model so that predicted RV volumes reached good agreement with CMR measurements (error <3%). Two RV/LV/patch models were made based on preoperation data to evaluate and compare two PVR surgical procedures: (i) conventional patch with little or no scar tissue trimming, and (ii) small patch with aggressive scar trimming and RV volume reduction. Our modeling results indicated that (a) patient-specific CMR-based computational modeling can provide accurate assessment of RV cardiac functions, and (b) PVR with a smaller patch and more aggressive scar removal led to reduced stress/strain conditions in the patch area and may lead to improved recovery of RV functions. More patient studies are needed to validate our findings.

scholarly journals Analysis of right ventricle function with strain imaging before and after pulmonary valve replacement

2016 ◽  
Vol 23 (2) ◽  
pp. 195-201 ◽  
Author(s):  
Hazım Alper Gursu ◽  
Birgul Varan ◽  
Elif Sade ◽  
Ilkay Erdogan ◽  
Murat Ozkan
Keyword(s):  
Right Ventricle ◽  
Valve Replacement ◽  
Pulmonary Valve ◽  
Strain Imaging ◽  
Pulmonary Valve Replacement ◽  
Right Ventricle Function ◽  
Before And After ◽  
Ventricle Function

scholarly journals Timing of pulmonary valve replacement in patients with corrected Fallot to prevent QRS prolongation

2020 ◽  
Vol 58 (3) ◽  
pp. 559-566
Author(s):  
Jamie L R Romeo ◽  
Johanna J M Takkenberg ◽  
Judith A A E Cuypers ◽  
Natasha M S de Groot ◽  
Pieter van de Woestijne ◽  
...  
Keyword(s):  
Valve Replacement ◽  
Pulmonary Valve ◽  
Pulmonary Valve Replacement ◽  
Older Age ◽  
Time Interval ◽  
Early Model ◽  
Mixed Effect ◽  
Qrs Prolongation ◽  
Before And After ◽  
Qrs Duration

Abstract OBJECTIVES Timing of pulmonary valve replacement (PVR) remains one of the most heavily debated topics in congenital cardiac surgery. We aimed to analyse the temporal evolution of QRS duration before and after PVR. METHODS We included 158 consecutive patients who underwent PVR after previous correction with transannular patch. All 3549 available serial standard 12-lead surface QRS measurements of 158 (100%) patients were analysed with linear mixed-effect modelling. RESULTS PVR was performed at a mean age of 28.0 ± 10.7 years, 23.4 ± 8.4 years after correction. Hospital survival was 98.1%. A longer time interval between ToF correction and PVR (P &lt; 0.001), and an older age at correction (P = 0.015) were predictive of progressive QRS prolongation after PVR. Women on average had a shorter QRS duration (P = 0.005) after PVR. The model predicted that in patients corrected early (model age 0.5 years), PVR within 17 years after correction leads to narrowing or stabilization of QRS width. PVR beyond 17 years was associated with prolongation of QRS duration. In a patient corrected late (model age 5 years), PVR has to be performed within 15 years after correction to prevent prolongation. Finally, a longer time period between correction and PVR was associated with an increased hazard of cardiac death (hazard ratio 1.097, 95% confidence interval 1.002–1.200). CONCLUSIONS Prolongation of QRS duration after PVR was associated with a longer time between correction and PVR, older age at correction and male sex. Prevention of progressive QRS prolongation by earlier PVR can potentially reduce the hazard of adverse events after PVR.

scholarly journals Changes in left and right ventricular longitudinal function after pulmonary valve replacement in patients with Tetralogy of Fallot

2020 ◽  
Vol 318 (2) ◽  
pp. H345-H353 ◽  
Author(s):  
Pia Sjöberg ◽  
Ellen Ostenfeld ◽  
Erik Hedström ◽  
Håkan Arheden ◽  
Ronny Gustafsson ◽  
...  
Keyword(s):  
Tetralogy Of Fallot ◽  
Valve Replacement ◽  
Pulmonary Valve ◽  
Pulmonary Regurgitation ◽  
Pulmonary Valve Replacement ◽  
Left Ventricular ◽  
Longitudinal Function ◽  
Before And After ◽  
Atrioventricular Plane Displacement ◽  
Plane Displacement

Timing and indication for pulmonary valve replacement (PVR) in patients with repaired Tetralogy of Fallot (rToF) and pulmonary regurgitation (PR) are uncertain. To improve understanding of pumping mechanics, we investigated atrioventricular coupling before and after surgical PVR. Cardiovascular magnetic resonance was performed in patients ( n = 12) with rToF and PR > 35% before and after PVR and in healthy controls ( n = 15). Atrioventricular plane displacement (AVPD), global longitudinal peak systolic strain (GLS), atrial and ventricular volumes, and caval blood flows were analyzed. Right ventricular (RV) AVPD and RV free wall GLS were lower in patients before PVR compared with controls ( P < 0.0001; P < 0.01) and decreased after PVR ( P < 0.0001 for both). Left ventricular AVPD was lower in patients before PVR compared with controls ( P < 0.05) and decreased after PVR ( P < 0.01). Left ventricular GLS did not differ between patients and controls ( P > 0.05). Right atrial reservoir volume and RV stroke volume generated by AVPD correlated in controls ( r = 0.93; P < 0.0001) and patients before PVR ( r = 0.88; P < 0.001) but not after PVR. In conclusion, there is a clear atrioventricular coupling in patients before PVR that is lost after PVR, possibly because of loss of pericardial integrity. Impaired atrioventricular coupling complicates assessment of ventricular function after surgery using measurements of longitudinal function. Changes in atrioventricular coupling seen in patients with rToF may be energetically unfavorable, and long-term effects of surgery on atrioventricular coupling is therefore of interest. Also, AVPD and GLS cannot be used interchangeably to assess longitudinal function in rToF. NEW & NOTEWORTHY There is a clear atrioventricular coupling in patients with Tetralogy of Fallot (ToF) and pulmonary regurgitation before surgical pulmonary valve replacement (PVR) that is lost after operation, possibly because of loss of pericardial integrity. The impaired atrioventricular coupling complicates assessment of ventricular function after surgery when using measurements of longitudinal function. Left ventricular atrioventricular plane displacement (AVPD) found differences between patients and controls and changes after PVR that longitudinal strain could not detect. This indicates that AVPD and strain cannot be used interchangeably to assess longitudinal function in repaired ToF.

scholarly journals Unchanged right ventricular strain in repaired tetralogy of Fallot after pulmonary valve replacement with radial long-axis cine magnetic resonance images

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Masateru Kawakubo ◽  
Yuzo Yamasaki ◽  
Daisuke Toyomura ◽  
Kenichiro Yamamura ◽  
Ichiro Sakamoto ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Right Ventricular ◽  
Tetralogy Of Fallot ◽  
Valve Replacement ◽  
Pulmonary Valve ◽  
Pulmonary Valve Replacement ◽  
Control Group ◽  
Short Axis ◽  
Short Axis Cine ◽  
Before And After

AbstractWe measured right ventricular (RV) strain by applying a novel postprocessing technique to conventional short-axis cine magnetic resonance imaging in the repaired tetralogy of Fallot (TOF) and investigated whether pulmonary valve replacement (PVR) changes the RV strain. Twenty-four patients with repaired TOF who underwent PVR and 16 healthy controls were enrolled. Global maximum and minimum principal strains (GPSmax, GPSmin) and global circumferential and longitudinal strains (GCS, GLS) were measured from short-axis cine images reconstructed radially along the long axis. Strain parameters before and after PVR were compared using paired t-tests. One-way ANOVA with Tukey post-hoc analysis was used for comparisons between the before and after PVR groups and the control group. There were no differences in strain parameters before and after PVR. The GPSmax before PVR was lower than that in the control group (P = 0.002). Before and after PVR, GCSs were higher and GLSs were lower than those in the control group (before and after GCSs: P = 0.002 for both, before and after GLSs: P < 0.0001 and P = 0.0003). RV strains from radially reconstructed short-axis cine images revealed unchanged myocardial motion after PVR. When compared to the control group, changes in GCS and GLS in TOF patients before and after PVR might be due to RV remodeling.

scholarly journals Right Ventricular Strain in Repaired Tetralogy of Fallot After Pulmonary Valve Replacement With Reconstructed Radial Long-axis Cine Magnetic Resonance Images

2021 ◽  
Author(s):  
Masateru Kawakubo ◽  
Yuzo Yamasaki ◽  
Daisuke Toyomura ◽  
Kenichiro Yamamura ◽  
Ichiro Sakamoto ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Tetralogy Of Fallot ◽  
Valve Replacement ◽  
Pulmonary Valve ◽  
Pulmonary Valve Replacement ◽  
Control Group ◽  
Short Axis ◽  
Short Axis Cine ◽  
Repaired Tetralogy Of Fallot ◽  
Before And After

Abstract Objectives: To investigate changes in right ventricular (RV) strain after pulmonary valve replacement (PVR) in repaired tetralogy of Fallot (TOF) by applying a novel postprocessing technique to conventional short-axis cine MRI to measure RV strains before and after PVR.Methods: Twenty-four patients with repaired TOF who underwent PVR and 16 healthy controls were enrolled. Global maximum and minimum principal strains (GPSmax, GPSmin) and global circumferential and longitudinal strains (GCS, GLS) were measured from short-axis cine images reconstructed radially along the long axis. Strain parameters before and after PVR were compared using paired t-tests. One-way ANOVA with Tukey post-hoc analysis was used for comparisons between the before and after PVR groups and the control group. Results: There were no differences in strain parameters before and after PVR. The GPSmax before PVR was lower than that in the control group (P=0.002). Before and after PVR, GCSs were higher and GLSs were lower than those in the control group (before and after GCSs: P=0.002 for both, before and after GLSs: P<0.0001 and P=0.0003). Conclusions: RV strains from radially reconstructed short-axis cine images revealed impaired myocardial motion after PVR. When compared to the control group, changes in GCS and GLS in TOF patients before and after PVR might be due to RV remodeling.

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