Congenital heart diseaseEffects of Morphologic Left Ventricular Pressure on Right Ventricular Geometry and Tricuspid Valve Regurgitation in Patients With Congenitally Corrected Transposition of the Great Arteries
Section snippets
Methods
Review of the University of Michigan Health System's Division of Pediatric Cardiology echocardiographic database identified all patients with CCTGA who underwent surgical interventions that were expected to alter the LV/RV pressure ratio while leaving the right ventricle as the systemic ventricle. Patients requiring single-ventricle palliation were excluded. We examined 2 groups of patients. Those in group 1 underwent PA banding to increase LV pressure in preparation for eventual double-switch
Results
Fourteen patients with CCTGA underwent PA banding placement for retraining of the morphologic left ventricle (group 1). The median age in this group was 1.1 years (range 0 to 12.1). Associated lesions included small ventricular septal defects; mild pulmonary stenosis; thickened, apically displaced tricuspid valves; and complete heart block, with 2 patients requiring pacemakers preoperatively and 2 additional patients requiring 1 postoperatively (Table 1). The median time interval between
Discussion
In this study, we evaluated the effect of procedures that changed predominately the LV pressure on the RV geometry, tricuspid valve geometry and the degree of TR. Patients who underwent banding of the pulmonary artery with increases in LV pressure to ≥2/3 RV pressure developed less spherical right ventricles and more spherical left ventricles with decreased TR. Because no patients in the PA banding group had substantial left ventricle–to–right ventricle shunts, PA banding should not have
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