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Erschienen in: Pediatric Cardiology 3/2014

01.03.2014 | Original Article

Altered Right Ventricular Function in the Long-Term Follow-up Evaluation of Patients After Delayed Aortic Reimplantation of the Anomalous Left Coronary Artery From the Pulmonary Artery

verfasst von: Rita Schuck, Mohamed Y. Abd El Rahman, Axel Rentzsch, Wei Hui, Yuguo Weng, Vladimir Alexi-Meskishvili, Peter E. Lange, Felix Berger, Hashim Abdul-Khaliq

Erschienen in: Pediatric Cardiology | Ausgabe 3/2014

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Abstract

This study aimed to evaluate regional and global ventricular functions in the long term after aortic reimplantation of the anomalous left coronary artery from the pulmonary artery (ALCAPA) and to assess whether the time of surgical repair influences ventricular performance.The study examined 20 patients with a median age of 15 years (range 3–37 years) who had a corrected ALCAPA and 20 age-matched control subjects using echocardiography and tissue Doppler imaging (TDI). The median follow-up period after corrective surgery was 6 years (range 2.6–15 years). Seven patients underwent surgery before the age of 3 years (early-surgery group), whereas 13 patients had surgery after that age (late-surgery group). The TDI-derived myocardial strain of the interventricular septum (IVS), lateral wall of the left ventricle (LV), and lateral wall of the right ventricle (RV) in the basal and mid regions were examined, and a mean was calculated. The pulsed Doppler-derived Tei index was used to assess global left ventricular function. No significant differences were found between the early-surgery group and the control group regarding the regional myocardial strain or the Tei index. Compared with the early-surgery group, the late-surgery group had a significantly higher Tei index (mean 0.37; range 0.31–0.42 vs. mean 0.52; range 0.39–0.69; p < 0.005), a lower strain percentage of the lateral wall of the LV (mean 29; range 17–30 vs. mean 9; range 7–23), IVS (mean 23; range 21–31 vs. mean 19; range 13–25), and lateral wall of the RV (mean 23; range 21–31 vs. mean 19; range 13–25). The age at operation correlated significantly with the Tei index (r = 0.84, p < 0.001) and inversely with the mean strain of the lateral wall of the LV (r = −0.53, p = 0.028), IVS (r = −0.68, p = 0.003), and lateral wall of the RV (r = −0.68, p = 0.003). At the midterm follow-up evaluation after corrective surgery of ALCAPA, not only the left but also the right ventricular function seemed to be affected in patients with delayed diagnosis and late surgical repair but preserved among the younger patients with early diagnosis and corrective surgery.
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Metadaten
Titel
Altered Right Ventricular Function in the Long-Term Follow-up Evaluation of Patients After Delayed Aortic Reimplantation of the Anomalous Left Coronary Artery From the Pulmonary Artery
verfasst von
Rita Schuck
Mohamed Y. Abd El Rahman
Axel Rentzsch
Wei Hui
Yuguo Weng
Vladimir Alexi-Meskishvili
Peter E. Lange
Felix Berger
Hashim Abdul-Khaliq
Publikationsdatum
01.03.2014
Verlag
Springer US
Erschienen in
Pediatric Cardiology / Ausgabe 3/2014
Print ISSN: 0172-0643
Elektronische ISSN: 1432-1971
DOI
https://doi.org/10.1007/s00246-013-0819-9

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