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Predicting outcome of pulmonary valve replacement in adult tetralogy of Fallot patients.
Ann Thorac Surg. 2007 Mar; 83(3):907-11.AT

Abstract

BACKGROUND

Predicting changes in right ventricular (RV) size and function after pulmonary valve replacement (PVR) is important for timely reintervention in adult tetralogy of Fallot patients.

METHODS

We analyzed the influence of pulmonary regurgitation severity and RV size and function before PVR on the outcome of RV size and function after PVR in 27 adult Fallot patients who had cardiac magnetic resonance imaging before and after PVR. RV dimensions were indexed for body surface area.

RESULTS

Pulmonary regurgitation (48% +/- 11% of RV stroke volume) was not related to RV dimensions and function before PVR. Moreover, severity of pulmonary regurgitation did not influence changes in RV dimensions after PVR. The indexed RV end-systolic volume before PVR (mean, 98 mL/m2; range, 52 to 235 mL/m2) best predicted the indexed RV end-systolic volume after PVR (mean, 59 mL/m2; range, 24 to 132 mL/m2, r = 0.78, p < 0.001) and the indexed RV end-diastolic volume after PVR (mean, 107 mL/m2; range, 70 to 170 mL/m2, r = 0.73, p < 0.001). Baseline RV ejection fraction corrected for valvular insufficiencies and shunting (21% +/- 7%) best predicted the RV ejection fraction after PVR (43% +/- 10%, r = 0.77, p < 0.001).

CONCLUSIONS

Timing of PVR should be based on indexed RV end-systolic volume and corrected RV ejection fraction rather than on severity of pulmonary regurgitation.

Authors+Show Affiliations

Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17307432

Citation

Henkens, Ivo R., et al. "Predicting Outcome of Pulmonary Valve Replacement in Adult Tetralogy of Fallot Patients." The Annals of Thoracic Surgery, vol. 83, no. 3, 2007, pp. 907-11.
Henkens IR, van Straten A, Schalij MJ, et al. Predicting outcome of pulmonary valve replacement in adult tetralogy of Fallot patients. Ann Thorac Surg. 2007;83(3):907-11.
Henkens, I. R., van Straten, A., Schalij, M. J., Hazekamp, M. G., de Roos, A., van der Wall, E. E., & Vliegen, H. W. (2007). Predicting outcome of pulmonary valve replacement in adult tetralogy of Fallot patients. The Annals of Thoracic Surgery, 83(3), 907-11.
Henkens IR, et al. Predicting Outcome of Pulmonary Valve Replacement in Adult Tetralogy of Fallot Patients. Ann Thorac Surg. 2007;83(3):907-11. PubMed PMID: 17307432.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Predicting outcome of pulmonary valve replacement in adult tetralogy of Fallot patients. AU - Henkens,Ivo R, AU - van Straten,Alexander, AU - Schalij,Martin J, AU - Hazekamp,Mark G, AU - de Roos,Albert, AU - van der Wall,Ernst E, AU - Vliegen,Hubert W, PY - 2006/07/10/received PY - 2006/09/26/revised PY - 2006/09/26/accepted PY - 2007/2/20/pubmed PY - 2007/3/31/medline PY - 2007/2/20/entrez SP - 907 EP - 11 JF - The Annals of thoracic surgery JO - Ann. Thorac. Surg. VL - 83 IS - 3 N2 - BACKGROUND: Predicting changes in right ventricular (RV) size and function after pulmonary valve replacement (PVR) is important for timely reintervention in adult tetralogy of Fallot patients. METHODS: We analyzed the influence of pulmonary regurgitation severity and RV size and function before PVR on the outcome of RV size and function after PVR in 27 adult Fallot patients who had cardiac magnetic resonance imaging before and after PVR. RV dimensions were indexed for body surface area. RESULTS: Pulmonary regurgitation (48% +/- 11% of RV stroke volume) was not related to RV dimensions and function before PVR. Moreover, severity of pulmonary regurgitation did not influence changes in RV dimensions after PVR. The indexed RV end-systolic volume before PVR (mean, 98 mL/m2; range, 52 to 235 mL/m2) best predicted the indexed RV end-systolic volume after PVR (mean, 59 mL/m2; range, 24 to 132 mL/m2, r = 0.78, p < 0.001) and the indexed RV end-diastolic volume after PVR (mean, 107 mL/m2; range, 70 to 170 mL/m2, r = 0.73, p < 0.001). Baseline RV ejection fraction corrected for valvular insufficiencies and shunting (21% +/- 7%) best predicted the RV ejection fraction after PVR (43% +/- 10%, r = 0.77, p < 0.001). CONCLUSIONS: Timing of PVR should be based on indexed RV end-systolic volume and corrected RV ejection fraction rather than on severity of pulmonary regurgitation. SN - 1552-6259 UR - https://www.unboundmedicine.com/medline/citation/17307432/Predicting_outcome_of_pulmonary_valve_replacement_in_adult_tetralogy_of_Fallot_patients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0003-4975(06)01916-3 DB - PRIME DP - Unbound Medicine ER -