Imaging in repaired tetralogy of Fallot with a focus on recent advances in echocardiography

Larios, Guillermo; Friedberg, Mark K.

doi:10.1097/hco.0000000000000426

Cited by 12 publications

(19 citation statements)

References 122 publications

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“…[8] In recent years, threedimensional echocardiography has been developed as a useful technique for quantification of ventricular volumes. [9] Due to the complex anatomy of RV, it is very difficult to evaluate RV function with conventional echocardiography in operated TOF patients.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of right ventricular function in operated tetralogy of Fallot patients with tissue Doppler imaging before and after pulmonary valve replacement

Gürsu

Varan

Erdoğan

et al. 2018

Turk Gogus Kalp Dama

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Background:This study aims to investigate the efficacy of tissue Doppler echocardiography for the diagnosis of right ventricular dysfunction and for the evaluation of the response to pulmonary valve replacement. Methods: Between December 2008 and December 2010, a total of 15 patients (8 males, 7 females; mean age: 14.5±4.5 years; range, 7 to 22 years) with pulmonary valve insufficiency in the follow-up of total correction of tetralogy of Fallot who underwent pulmonary valve replacement were included in the study. Echocardiographic imaging was performed before and one, three, and six months after replacement. Using pulse wave Doppler, early diastolic E and late diastolic A waves were measured in the flow velocity curve of tricuspid valve. Tissue Doppler measurements were made from the basal segment of right ventricular free wall and interventricular septum. S, e, and a myocardial velocities, isometric contraction time, isovolumetric relaxation time and ejection time were measured. Myocardial performance index was calculated for each patient. Results:In pre-pulmonary valve replacement phase, s, e, a velocities and ejection time were lower in the interventricular septum compared to the basal segment of right ventricular free wall, while isometric contraction time, isovolumetric relaxation time and myocardial performance index values were higher. In the first post-replacement month, there was a significant decrease in the s value of interventricular septum, compared to pre-pulmonary valve replacement period; isometric contraction time decreased and myocardial performance index increased in the first postpulmonary valve replacement month in the free wall of right ventricle, while isovolumetric relaxation time decreased in the postoperative third month, and s velocity, isometric contraction time and myocardial performance index increased in the postoperative sixth month. Pre-pulmonary valve replacement tissue Doppler values at the septum showed that myocardial systolic and diastolic dysfunction developed earlier than the basal segment of right ventricular free wall. This result showed that right ventricular recovery was not complete in the sixth post-pulmonary valve replacement month. Conclusion:Tissue Doppler can show right ventricular dysfunction before replacement, but it may be insufficient to visualize right ventricular recovery until six months after treatment.

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Section: Discussionmentioning

confidence: 99%

Evaluation of right ventricular function in operated tetralogy of Fallot patients with tissue Doppler imaging before and after pulmonary valve replacement

Gürsu

Varan

Erdoğan

et al. 2018

Turk Gogus Kalp Dama

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“…Echocardiographic evaluation should include the assessment of residual RVOT obstruction and proximal pulmonary artery branches. RVOT views from parasternal short and long-axis are the standard echocardiographic views for assessing the RVOT [5,44]. Pulsed and continuous wave Doppler are used for the assessment of gradients.…”

Section: Repaired Tetralogy Of Fallotmentioning

confidence: 99%

“…The assessment of severity of pulmonary regurgitation is based on parasternal short and long-axis views and includes assessment of jet width at valve level, diastolic flow reversal from the main and distal pulmonary artery branches and pulsed Doppler (pressure half-time <100 milliseconds). Generally, echocardiography is reliable in patients with hemodynamically significant pulmonary regurgitation [5,[44][45].…”

Section: Repaired Tetralogy Of Fallotmentioning

confidence: 99%

Imaging the adult with congenital heart disease: a multimodality imaging approach—position paper from the EACVI

Salvo

Miller

Babu‐Narayan

et al. 2018

European Heart Journal - Cardiovascular Imaging

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Advances in the diagnosis and management of congenital heart disease have led to a marked improvement in the survival of adult with congenital heart disease (ACHD) patients. However, ACHD patients are a heterogeneous population, with a large spectrum of anatomic substrates even within specific lesions. In addition, the nature of previous surgery and other intervention is highly variable rendering each patient unique and residual anatomic and haemodynamic abnormalities are very common. As the ACHD population continues to age, acquired heart disease will also require cardiac imaging assessment. It is increasingly recognized in ACHD community that the diagnostic utility of a multimodality cardiovascular approach is greater than the sum of individual tests. In ACHD patients, diagnostic information can be obtained using a variety of diagnostic tools. The aims of this document are to describe the role of each diagnostic modality in the care of ACHD patients and to provide guidelines for a multimodality approach. The goal should be to provide the most appropriate and cost-effective diagnostic pathway for each individual ACHD patient.

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“…Tetralogy of Fallot (ToF) is one of the most prevalent congenital heart diseases encountered in adulthood. Owing to successful intervention in infancy, patient survival and subsequent quality of life has been dramatically improved in this population (1). Nevertheless, late cardiac complications, such as signi cant residual pulmonary regurgitation (PR), right ventricular (RV) dilatation and dysfunction, left ventricular (LV) dysfunction and arrhythmias are common (2).…”

Section: Introductionmentioning

confidence: 99%

Multi-plane echocardiographic assessment of right ventricular function in adults with repaired Tetralogy of Fallot

Bowen

Berendoncks

McGhie

et al. 2021

Preprint

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Background In patients with repaired Tetralogy of Fallot (ToF), detailed assessment of right ventricular (RV) function is important for management and timing of possible pulmonary valve re-intervention. The aim of this study was to evaluate RV function using two-dimensional multi-plane echocardiography (2D MPE), a novel four-wall imaging method obtained from one apical acoustic window utilising electronic plane rotation. Methods and Results In sixty-two ToF patients (aged - 28 [22, 39] years, 65 % male), systolic function of four different RV walls (lateral, anterior, inferior and inferior coronal) were evaluated using MPE. Tricuspid annular plane systolic excursion (TAPSE), tricuspid annular peak systolic velocity (RV-S’) and RV wall longitudinal strain (RV-LS) measurements were compared with those of matched healthy individuals. 2D MPE measurements were highly feasible across the four RV walls (93.5-100% for TAPSE/S’; 66.1-95.1% for RV-LS) and could be performed more reliably than 3D RV ejection fraction (RVEF - 56.5%). All functional values were significantly reduced when compared to the control group (p<0.001). Higher RV-LS values were seen in the lateral (-17.8±4.5%) and inferior (-17.8±4.2%) walls compared to the anterior (-15.9±3.8%) and inferior coronal (-15.1±3.9%) walls. 3D RVEF correlated strongest with RV-LS values from the lateral (r -0.50; p=0.002) and anterior walls (r -0.74; p<0.001) and furthermore the four-wall average (r -0.57; p=0.001). Conclusion 2D MPE evaluation of the RV is highly feasible in ToF patients. This novel method provides new insights into regional RV wall function, enabling a more comprehensive and quantitative approach to RV assessment in daily clinical practice.

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Imaging in repaired tetralogy of Fallot with a focus on recent advances in echocardiography

Abstract: Echocardiography and CMR have complementary and overlapping roles in rToF and contribute to our understanding of its pathophysiology and management.

Cited by 12 publications

References 122 publications

Evaluation of right ventricular function in operated tetralogy of Fallot patients with tissue Doppler imaging before and after pulmonary valve replacement

Evaluation of right ventricular function in operated tetralogy of Fallot patients with tissue Doppler imaging before and after pulmonary valve replacement

Imaging the adult with congenital heart disease: a multimodality imaging approach—position paper from the EACVI

Multi-plane echocardiographic assessment of right ventricular function in adults with repaired Tetralogy of Fallot

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