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Morphologic and functional changes of ventricles between pre- and post- cone reconstruction surgery in children with Ebstein’s anomaly / 中华胸心血管外科杂志
Article en Zh | WPRIM | ID: wpr-1029699
Biblioteca responsable: WPRO
ABSTRACT
Objective:To understand the morphologic and functional changes of ventricles between pre- and post- cone reconstruction(CR) surgery in children with Ebstein’s anomaly(EA).Methods:The clinical data of children with EA who underwent CR and cardiac magnetic resonance(CMR) in Shanghai Children’s Medical Center between July 2011 to April 2019 were collected and analyzed. Ventricular functions were assessed with the use of ejection fraction(EF), stroke volume index(SVI), cardiac output(CO), and cardiac index(CI). Ventricular morphologies were assessed with the use of end-diastolic ventricular volume(EDV), end-diastolic ventricular volume index(EDVI) and ventricular cine images. Paired student t tests and Wilcoxon rank sum tests were used for statistical analysis. Results:There were a total of 32 children with EA who underwent CR and CMR, with 13 males and 19 females, a median operative age of 2.9 years old(0.6-15.5 years old), and a mean follow-up time of(4.4±1.9) years. Seven patients had both preoperative and postoperative CMR, with a mean follow-up time of(3.3±1.4) years; Eleven patients had two or more postoperative CMR, with a mean interval time of(1.9±1.0) years. After the surgery, the median tricuspid-regurgitation grade decreased from 3 to 2, and the median New York Heart Association functional class improved from 2.5 to 1, the left ventricle(LV)-SVI, LV-EDV and LV-EDVI increased from 29.8 ml/m 2 to 43.2 ml/m 2( P=0.039), from 56.4 ml to 86.9 ml( P=0.004), from 50.5 ml/m 2 to 68.4 ml/m 2( P=0.022), respectively. And the long-term LV-EDV increased from 56.6 ml to 74.7 ml( P=0.002) when compared to that of early postoperative. There was no significant differences in right ventricle(RV)-EF, RV-SVI, RV-CO, RV-CI, RV-EDV and RV-EDVI between pre- and post- CR( P>0.05); but the long-term postoperative RV-CO and RV-EDV increased from 3.1 L/min to 4.1 L/min( P=0.008), from 67.5 ml to 96.5 ml( P<0.001), respectively, when compared with those of early postoperative. Conclusion:CR improves the function and morphology of both ventricles in children with EA. And although postoperative ventricles grow well, RV dysfunction persists.
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Texto completo: 1 Base de datos: WPRIM Idioma: Zh Revista: Chinese Journal of Thoracic and Cardiovascular Surgery Año: 2023 Tipo del documento: Article
Texto completo: 1 Base de datos: WPRIM Idioma: Zh Revista: Chinese Journal of Thoracic and Cardiovascular Surgery Año: 2023 Tipo del documento: Article