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 Right Ventricle Has Normal Myofilament Function But Shows Perturbations in the Expression of Extracellular Matrix Genes in Patients With Tetralogy of Fallot Undergoing Pulmonary Valve Replacement

2020 ◽  
Vol 9 (16) ◽  
Author(s):  
Daniel Brayson ◽  
So‐Jin Holohan ◽  
Sonya C. Bardswell ◽  
Matthew Arno ◽  
Han Lu ◽  
...  
Keyword(s):  
Extracellular Matrix ◽  
Right Ventricle ◽  
Tetralogy Of Fallot ◽  
Valve Replacement ◽  
Pulmonary Valve ◽  
Pulmonary Valve Replacement ◽  
Collagen Content ◽  
Valve Regurgitation ◽  
Tissue Samples ◽  
Pulmonary Valve Regurgitation

Background Patients with repair of tetralogy of Fallot (rToF) who are approaching adulthood often exhibit pulmonary valve regurgitation, leading to right ventricle (RV) dilatation and dysfunction. The regurgitation can be corrected by pulmonary valve replacement (PVR), but the optimal surgical timing remains under debate, mainly because of the poorly understood nature of RV remodeling in patients with rToF. The goal of this study was to probe for pathologic molecular, cellular, and tissue changes in the myocardium of patients with rToF at the time of PVR. Methods and Results We measured contractile function of permeabilized myocytes, collagen content of tissue samples, and the expression of mRNA and selected proteins in RV tissue samples from patients with rToF undergoing PVR for severe pulmonary valve regurgitation. The data were compared with nondiseased RV tissue from unused donor hearts. Contractile performance and passive stiffness of the myofilaments in permeabilized myocytes were similar in rToF‐PVR and RV donor samples, as was collagen content and cross‐linking. The patients with rToF undergoing PVR had enhanced mRNA expression of genes associated with connective tissue diseases and tissue remodeling, including the small leucine‐rich proteoglycans ASPN (asporin), LUM (lumican), and OGN (osteoglycin), although their protein levels were not significantly increased. Conclusions RV myofilaments from patients with rToF undergoing PVR showed no functional impairment, but the changes in extracellular matrix gene expression may indicate the early stages of remodeling. Our study found no evidence of major damage at the cellular and tissue levels in the RV of patients with rToF who underwent PVR according to current clinical criteria.

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 < 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 Impact of Mitral Valve Replacement on Right Ventricle Function in Immediate Post-Operative Period

2019 ◽  
Vol 71 ◽  
pp. S33
Author(s):  
A. Binny ◽  
N. Swaminathan ◽  
G. Gnanavelu ◽  
G. Ravishankar ◽  
G.J. Paul ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Right Ventricle ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Right Ventricle Function ◽  
Post Operative Period ◽  
Ventricle Function
Sign in / Sign up

Export Citation Format

Share Document