Quantification of regional right and left ventricular function by ultrasonic strain rate and strain indexes after surgical repair of tetralogy of fallot

Weidemann, Frank; Eyskens, Bénédicte; Mertens, Luc; Dommke, Christoph; Kowalski, Mirosław; Simmons, Lisa; Claus, Piet; Bijnens, Bart; Gewillig, Marc; Hatle, Liv; Sutherland, George R.

doi:10.1016/s0002-9149(02)02435-9

Cited by 146 publications

(85 citation statements)

References 18 publications

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“…Differences between asymptomatic (n = 6) and symptomatic (n = 9) patients before pulmonary valve replacement. Recently, strain and strain rate values obtained on the basis of tissue Doppler imaging has emerged as an advanced diagnostic procedure to determine regional myocardial function [3,4]. Tsang et al [5] found mean pre-replacement RV end-diastolic volume as 173 ± 44 mL/m 2 , RV end-systolic volume as 102 ± 26 mL/m 2 , and RVEF as 42 ± 9%, however mean RV end-diastolic volume was found as 103 ± 19 mL/m 2 , RV endsystolic volume was found as 54 ± 11 mL/m 2 , and RVEF was found as 47 ± 6% 1-2 years after replacement.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2016

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Section: Discussionmentioning

confidence: 99%

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

et al. 2016

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“…Furthermore, previous studies have used ejection-phase indices to determine RV function, which have their limitations in patients with abnormal loading conditions. 6,7 We have recently validated isovolumic myocardial acceleration (IVA) in an experimental and a clinical study as a new tissue Doppler based index of systolic RV function. 8,9 In addition to being a sensitive index of myocardial function, IVA was found to be less load-dependent than ejection-phase indices.…”

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confidence: 99%

Pulmonary Regurgitation Is an Important Determinant of Right Ventricular Contractile Dysfunction in Patients With Surgically Repaired Tetralogy of Fallot

et al. 2004

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“…Advanced echocardiographic assessment of RV function, including measurements of myocardial velocities, strain and strain rate, may provide new insight into RV function under abnormal loading conditions [19,20]. Decreased myocardial velocities and strain rate have been reported in patients after TOF repair compared to normal subjects, not only in the right ventricular free wall but also in the septum and in the left ventricular lateral wall [12,20,21]. This important observation suggests that patients after TOF repair may have decreased intrinsic myocardial contractility, not only of the RV, but also of the left ventricle.…”

Section: Volume Overloadmentioning

confidence: 99%

“…Several causes can be postulated, including chronic cyanosis before repair, intrinsic myocardial fibrosis, scars after open-heart surgery, and interventricular interactions. Frigiola et al, testing the parameters of RV myocardial contractility in different degrees of pulmonary valve regurgitation (mild, moderate, severe), identified the isovolumetric acceleration time of the right and the left ventricle, the size of the tricuspid valve ring and QRS duration as correlating with the degree of pulmonary regurgitation; in contrast, load-dependent myocardial velocities and strain were not influenced by the severity of pulmonary regurgitation [20].…”

Section: Volume Overloadmentioning

confidence: 99%

The right ventricle in tetralogy of Fallot

Stambach¹,

Valsangiacomo²

2009

Schweiz Ärzteztg

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Surgical repair of tetralogy of Fallot (TOF) may be followed by various conditions and residual findings, early postoperatively or late during follow-up. Most of these conditions affect the right ventricular outflow tract and the pulmonary arteries and thus, indirectly, the right ventricle.This paper discusses the role of the right ventricle during the natural history of repaired TOF. The different imaging methods used to assess the function of the right ventricle in relation to this congenital heart disease are highlighted. Particular attention is focused on the volume overloaded right ventricle, as this condition is nowadays a subject of intense discussion, particularly regarding the appropriate timing for pulmonary valve replacement. The most recent literature on this topic is briefly reviewed. In summary, preservation of right ventricular function and prevention of right ventricular arrhythmias are crucial for these patients' survival and outcome. Key words: right ventricle; tetralogy of Fallot; pulmonary regurgitation IntroductionTetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease, occurring in 0.04-0.08% of all liveborns [1, 2]. The main feature of TOF is a ventricular septum defect with anterior deviation of the outlet septum, leading to infundibular subpulmonary stenosis and placing the aorta in an overriding position; in addition, valvular pulmonary stenosis with possible hypoplasia of the main pulmonary artery and its side branches occurs, together with hypertrophy of the right ventricle (RV) ( fig. 1).Besides closing the ventricular septal defect, surgical repair consists of reconstruction of the right ventricular outflow tract (RVOT). RVOT reconstruction can be performed by various surgical techniques, some resulting in residual RVOT obstruction (commissurotomy) and others completely relieving the obstruction at the price of causing pulmonary regurgitation (transannular patch). Thus the surgical technique used usually determines the postoperative findings and eventually the patients' long-term outcome. However, the surgical technique providing the best outcome for the patients has not yet been defined, and the type of repair is chiefly determined by the personal strategy of the operating surgeon in each individual centre. Surgical repair can be performed during the first months of life, ideally at the age of 3 to 4 months, with low perioperative mortality. Long-term mortality was studied by Nollert et al., who reported a 20-year survival rate of 94% [3]. Nevertheless, the survival curve seems to deteriorate after 25 years post TOF repair [3], and significant residual findings may occur resulting in significant morbidity during follow-up. Similarly, Oechslin et al. reported a cumulative percentage of reinterventions required in TOF patients [4]. The most common indications for reintervention consisted of lesions affecting the (RVOT 75%), including severe pulmonary regurgitation, conduit failure and RVOT obstruction. Due to their anatomical location, all these findings may ev...

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Quantification of regional right and left ventricular function by ultrasonic strain rate and strain indexes after surgical repair of tetralogy of fallot

Cited by 146 publications

References 18 publications

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

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

Pulmonary Regurgitation Is an Important Determinant of Right Ventricular Contractile Dysfunction in Patients With Surgically Repaired Tetralogy of Fallot

The right ventricle in tetralogy of Fallot

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