Journal of the American Society of Echocardiography
Original articleRight Ventricular Mechanical Dyssynchrony in Children with Hypoplastic Left Heart Syndrome
Section snippets
Study Population
Patients between age 0 and 18 years with HLHS were identified from a pediatric echocardiography hospital database from echocardiograms performed between April 2005 and January 2006. Clinical data were obtained from the medical record. We included patients with a left ventricle (LV) that was inadequate to support the systemic circulation necessitating a Norwood type procedure in the neonatal period. Patients with HLHS were included at any stage of palliation: post-Norwood procedure (stage 1),
Results
Seventeen children with HLHS were identified. One patient was excluded because of external pacing, leaving 16 patients eligible for analysis. All had adequate echocardiographic images for VVI. Control subjects and children with HLHS were well matched for age (4.9 ± 4.6 vs 4.8 ± 4.4, not significant [NS]). Seven patients with HLHS had a RV-pulmonary artery conduit as part of their Norwood procedure, 7 patients had a Blalock-Taussig shunt as part of their Norwood procedure (if this information
Discussion
Intraventricular mechanical dyssynchrony is detrimental to ventricular function and predicts improved ventricular function in response to CRT.6 The results of this study show that mechanical dyssynchrony is prevalent in the systemic RV in HLHS. RV mechanical dyssynchrony may, therefore, constitute an additional detrimental factor in the development of RV dysfunction in HLHS in addition to other causes of RV dysfunction in HLHS. The presence of mechanical dyssynchrony in a patient with HLHS and
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Dr Friedberg was supported by a Glaser Pediatric Research Network fellowship.