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"Pulmonary valve replacement diminishes the presence of restrictive physiology and reduces atrial volumes": a prospective study in Tetralogy of Fallot patients.
Int J Cardiol. 2014 Nov 15; 177(1):261-5.IJ

Abstract

Pulmonary valve replacement (PVR) reduces right ventricular (RV) volumes in the setting of long-term pulmonary regurgitation after Tetralogy of Fallot (ToF) repair; however, little is known of its effect on RV diastolic function. Right atrial volumes may reflect the burden of RV diastolic dysfunction. The objective of this paper is to evaluate the clinical, echocardiographic, biochemical and cardiac magnetic resonance (CMR) variables, focusing particularly on right atrial response and right ventricular diastolic function prior to and after elective PVR in adult patients with ToF. This prospective study was conducted from January 2009 to April 2013 in consecutive patients > 18 years of age who had undergone ToF repair in childhood and were accepted for elective PVR. Twenty patients (mean age: 35 years; 70% men) agreed to enter the study. PVR was performed with a bioporcine prosthesis. Concomitant RV reduction was performed in all cases when technically possible. Pulmonary end-diastolic forward flow (EDFF) decreased significantly from 5.4 ml/m(2) to 0.3 ml/m(2) (p < 0.00001), and right atrial four-chamber echocardiographic measurements and volumes by 25% (p = 0.0024): mean indexed diastolic/systolic atrial volumes prior to surgery were 43 ml/m(2) (SD+/-4.6)/63 ml/m(2) (SD+/-5.5), and dropped to 33 ml/m(2) (SD+/-3)/46 ml/m(2) (SD+/-2.55) post-surgery. All patients presented right ventricular diastolic and systolic volume reductions, with a mean volume reduction of 35% (p < 0.00001). Right ventricular diastolic dysfunction was common in a population of severely dilated RV patients long term after ToF repair. Right ventricular diastolic parameters improved as did right atrial volumes in keeping with the known reduction in RV volumes, after PVR.

Authors+Show Affiliations

Integrated Hospital Vall d'Hebron-Hospital Sant Pau Adult Congenital Heart Disease Unit, Barcelona, Spain; Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain. Electronic address: tonyapijuan@hotmail.com.Department of Radiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.Department of Cardiovascular Surgery, Hospital Universitari Vall d'Hebron, Barcelona, Spain.Department of Cardiovascular Surgery, Hospital Universitari Vall d'Hebron, Barcelona, Spain.Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.Department of Biochemistry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.Integrated Hospital Vall d'Hebron-Hospital Sant Pau Adult Congenital Heart Disease Unit, Barcelona, Spain; Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.Integrated Hospital Vall d'Hebron-Hospital Sant Pau Adult Congenital Heart Disease Unit, Barcelona, Spain.Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.Integrated Hospital Vall d'Hebron-Hospital Sant Pau Adult Congenital Heart Disease Unit, Barcelona, Spain.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25499390

Citation

Pijuan-Domenech, Antonia, et al. ""Pulmonary Valve Replacement Diminishes the Presence of Restrictive Physiology and Reduces Atrial Volumes": a Prospective Study in Tetralogy of Fallot Patients." International Journal of Cardiology, vol. 177, no. 1, 2014, pp. 261-5.
Pijuan-Domenech A, Pineda V, Castro MA, et al. "Pulmonary valve replacement diminishes the presence of restrictive physiology and reduces atrial volumes": a prospective study in Tetralogy of Fallot patients. Int J Cardiol. 2014;177(1):261-5.
Pijuan-Domenech, A., Pineda, V., Castro, M. A., Sureda-Barbosa, C., Ribera, A., Cruz, L. M., Ferreira-Gonzalez, I., Dos-Subirà, L., Subirana-Domènech, T., Garcia-Dorado, D., & Casaldàliga-Ferrer, J. (2014). "Pulmonary valve replacement diminishes the presence of restrictive physiology and reduces atrial volumes": a prospective study in Tetralogy of Fallot patients. International Journal of Cardiology, 177(1), 261-5. https://doi.org/10.1016/j.ijcard.2014.09.009
Pijuan-Domenech A, et al. "Pulmonary Valve Replacement Diminishes the Presence of Restrictive Physiology and Reduces Atrial Volumes": a Prospective Study in Tetralogy of Fallot Patients. Int J Cardiol. 2014 Nov 15;177(1):261-5. PubMed PMID: 25499390.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - "Pulmonary valve replacement diminishes the presence of restrictive physiology and reduces atrial volumes": a prospective study in Tetralogy of Fallot patients. AU - Pijuan-Domenech,Antonia, AU - Pineda,Victor, AU - Castro,Miguel Angel, AU - Sureda-Barbosa,Carlos, AU - Ribera,Aida, AU - Cruz,Luz M, AU - Ferreira-Gonzalez,Ignacio, AU - Dos-Subirà,Laura, AU - Subirana-Domènech,Teresa, AU - Garcia-Dorado,David, AU - Casaldàliga-Ferrer,Jaume, Y1 - 2014/09/28/ PY - 2014/04/12/received PY - 2014/08/10/revised PY - 2014/09/15/accepted PY - 2014/12/16/entrez PY - 2014/12/17/pubmed PY - 2015/7/29/medline KW - Adult congenital heart disease KW - Diastolic dysfunction KW - Pulmonary valve replacement KW - Restrictive physiology KW - Tetralogy of Fallot SP - 261 EP - 5 JF - International journal of cardiology JO - Int. J. Cardiol. VL - 177 IS - 1 N2 - Pulmonary valve replacement (PVR) reduces right ventricular (RV) volumes in the setting of long-term pulmonary regurgitation after Tetralogy of Fallot (ToF) repair; however, little is known of its effect on RV diastolic function. Right atrial volumes may reflect the burden of RV diastolic dysfunction. The objective of this paper is to evaluate the clinical, echocardiographic, biochemical and cardiac magnetic resonance (CMR) variables, focusing particularly on right atrial response and right ventricular diastolic function prior to and after elective PVR in adult patients with ToF. This prospective study was conducted from January 2009 to April 2013 in consecutive patients > 18 years of age who had undergone ToF repair in childhood and were accepted for elective PVR. Twenty patients (mean age: 35 years; 70% men) agreed to enter the study. PVR was performed with a bioporcine prosthesis. Concomitant RV reduction was performed in all cases when technically possible. Pulmonary end-diastolic forward flow (EDFF) decreased significantly from 5.4 ml/m(2) to 0.3 ml/m(2) (p < 0.00001), and right atrial four-chamber echocardiographic measurements and volumes by 25% (p = 0.0024): mean indexed diastolic/systolic atrial volumes prior to surgery were 43 ml/m(2) (SD+/-4.6)/63 ml/m(2) (SD+/-5.5), and dropped to 33 ml/m(2) (SD+/-3)/46 ml/m(2) (SD+/-2.55) post-surgery. All patients presented right ventricular diastolic and systolic volume reductions, with a mean volume reduction of 35% (p < 0.00001). Right ventricular diastolic dysfunction was common in a population of severely dilated RV patients long term after ToF repair. Right ventricular diastolic parameters improved as did right atrial volumes in keeping with the known reduction in RV volumes, after PVR. SN - 1874-1754 UR - https://www.unboundmedicine.com/medline/citation/25499390/"Pulmonary_valve_replacement_diminishes_the_presence_of_restrictive_physiology_and_reduces_atrial_volumes":_a_prospective_study_in_Tetralogy_of_Fallot_patients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0167-5273(14)01711-2 DB - PRIME DP - Unbound Medicine ER -