Change in biventricular function after cone reconstruction of Ebstein's anomaly: an echocardiographic study
The Cone reconstruction in Ebstein's anomaly (EA) aims to reduce tricuspid valve regurgitation (TR) and reposition the valve to the anatomic annulus, but post-operative progress of ventricular function is poorly understood. This study evaluated biventricular function after Cone reconstruction u...
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| Veröffentlicht in: | European heart journal cardiovascular imaging 2018-07, Vol.19 (7), p.808-815 |
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| creator | Perdreau, E Tsang, V Hughes, M L Ibrahim, M Kataria, S Janagarajan, K Iriart, X Khambadkone, S Marek, J |
| description | The Cone reconstruction in Ebstein's anomaly (EA) aims to reduce tricuspid valve regurgitation (TR) and reposition the valve to the anatomic annulus, but post-operative progress of ventricular function is poorly understood. This study evaluated biventricular function after Cone reconstruction using echocardiographic techniques.
A retrospective study assessing longitudinal change was conducted from 2009 to 2014. All symptomatic patients with EA and severe TR undergoing surgery were included. Transthoracic advanced echocardiography was performed pre- and post-operatively (at short-term ( |
| doi_str_mv | 10.1093/ehjci/jex186 |
| format | Article |
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A retrospective study assessing longitudinal change was conducted from 2009 to 2014. All symptomatic patients with EA and severe TR undergoing surgery were included. Transthoracic advanced echocardiography was performed pre- and post-operatively (at short-term (<30 days) and mid-term). Conventional and longitudinal 2D strain parameters were measured for left ventricle (LV) and right ventricle (RV). Paired analyses were compared using Wilcoxon Matched-pairs signed rank test. From the 38 patients operated for EA, the echocardiographic data of 17 patients, aged 15 (1-57 years) at operation could be analysed. Median follow up was 6 months (8 days-54 months). The tricuspid annular plane systolic excursion (26.42 ± 5.79 mm vs. 8.75 ± 3.18 mm, P < 0.001), RV fractional area change (FAC) (45.00 ± 8.13% vs. 35.46 ± 5.76%, P = 0.038) and LV 2D peak systolic strain were significantly reduced post-operatively (-20.49 ± 2.79 vs. -17.73 ± 2.76, P = 0.041), with a trend to later recovery for LV 2D strain. There was no evidence of systolic mechanical dys-synchrony before or after operation.
Although clinical outcome of Cone reconstruction for EA remains excellent, acute post-operative changes leads to reduction of myocardial function of both ventricles, with a trend to later recovery for LV. Continuing impairment of RV function is multifactorial but may reflect intrinsic myocardial deficiency.</description><identifier>ISSN: 2047-2404</identifier><identifier>EISSN: 2047-2412</identifier><identifier>DOI: 10.1093/ehjci/jex186</identifier><identifier>PMID: 28950308</identifier><language>eng</language><publisher>England</publisher><subject>Adolescent ; Adult ; Cardiac Surgical Procedures - adverse effects ; Cardiac Surgical Procedures - methods ; Child ; Child, Preschool ; Cohort Studies ; Ebstein Anomaly - diagnostic imaging ; Ebstein Anomaly - surgery ; Echocardiography - methods ; Female ; Humans ; Image Interpretation, Computer-Assisted ; Infant ; Male ; Middle Aged ; Observer Variation ; Postoperative Complications - diagnostic imaging ; Postoperative Complications - epidemiology ; Postoperative Complications - physiopathology ; Prognosis ; Reference Values ; Retrospective Studies ; Risk Assessment ; Treatment Outcome ; Tricuspid Valve Insufficiency - diagnostic imaging ; Tricuspid Valve Insufficiency - prevention & control ; Ventricular Dysfunction, Right - diagnostic imaging ; Ventricular Dysfunction, Right - etiology ; Young Adult</subject><ispartof>European heart journal cardiovascular imaging, 2018-07, Vol.19 (7), p.808-815</ispartof><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c329t-b2670df9ea939680d9e8fea3ddded954abafc638255bd762e60590028716fbeb3</citedby><cites>FETCH-LOGICAL-c329t-b2670df9ea939680d9e8fea3ddded954abafc638255bd762e60590028716fbeb3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27922,27923</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28950308$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Perdreau, E</creatorcontrib><creatorcontrib>Tsang, V</creatorcontrib><creatorcontrib>Hughes, M L</creatorcontrib><creatorcontrib>Ibrahim, M</creatorcontrib><creatorcontrib>Kataria, S</creatorcontrib><creatorcontrib>Janagarajan, K</creatorcontrib><creatorcontrib>Iriart, X</creatorcontrib><creatorcontrib>Khambadkone, S</creatorcontrib><creatorcontrib>Marek, J</creatorcontrib><title>Change in biventricular function after cone reconstruction of Ebstein's anomaly: an echocardiographic study</title><title>European heart journal cardiovascular imaging</title><addtitle>Eur Heart J Cardiovasc Imaging</addtitle><description>The Cone reconstruction in Ebstein's anomaly (EA) aims to reduce tricuspid valve regurgitation (TR) and reposition the valve to the anatomic annulus, but post-operative progress of ventricular function is poorly understood. This study evaluated biventricular function after Cone reconstruction using echocardiographic techniques.
A retrospective study assessing longitudinal change was conducted from 2009 to 2014. All symptomatic patients with EA and severe TR undergoing surgery were included. Transthoracic advanced echocardiography was performed pre- and post-operatively (at short-term (<30 days) and mid-term). Conventional and longitudinal 2D strain parameters were measured for left ventricle (LV) and right ventricle (RV). Paired analyses were compared using Wilcoxon Matched-pairs signed rank test. From the 38 patients operated for EA, the echocardiographic data of 17 patients, aged 15 (1-57 years) at operation could be analysed. Median follow up was 6 months (8 days-54 months). The tricuspid annular plane systolic excursion (26.42 ± 5.79 mm vs. 8.75 ± 3.18 mm, P < 0.001), RV fractional area change (FAC) (45.00 ± 8.13% vs. 35.46 ± 5.76%, P = 0.038) and LV 2D peak systolic strain were significantly reduced post-operatively (-20.49 ± 2.79 vs. -17.73 ± 2.76, P = 0.041), with a trend to later recovery for LV 2D strain. There was no evidence of systolic mechanical dys-synchrony before or after operation.
Although clinical outcome of Cone reconstruction for EA remains excellent, acute post-operative changes leads to reduction of myocardial function of both ventricles, with a trend to later recovery for LV. Continuing impairment of RV function is multifactorial but may reflect intrinsic myocardial deficiency.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Cardiac Surgical Procedures - adverse effects</subject><subject>Cardiac Surgical Procedures - methods</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Cohort Studies</subject><subject>Ebstein Anomaly - diagnostic imaging</subject><subject>Ebstein Anomaly - surgery</subject><subject>Echocardiography - methods</subject><subject>Female</subject><subject>Humans</subject><subject>Image Interpretation, Computer-Assisted</subject><subject>Infant</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Observer Variation</subject><subject>Postoperative Complications - diagnostic imaging</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - physiopathology</subject><subject>Prognosis</subject><subject>Reference Values</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Treatment Outcome</subject><subject>Tricuspid Valve Insufficiency - diagnostic imaging</subject><subject>Tricuspid Valve Insufficiency - prevention & control</subject><subject>Ventricular Dysfunction, Right - diagnostic imaging</subject><subject>Ventricular Dysfunction, Right - etiology</subject><subject>Young Adult</subject><issn>2047-2404</issn><issn>2047-2412</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kD1PwzAURS0EolXpxoy8wUCoYztuzIaq8iFVYoE5cuzn1iW1i50g-u8JtPQt90rv6A4Hocuc3OVEsgms1tpN1vCdl-IEDSnh04zynJ4eO-EDNE5pTforuOA0P0cDWsqCMFIO0cdspfwSsPO4dl_g2-h016iIbed164LHyrYQsQ4ecIQ-Uhu7_SdYPK9TC85fJ6x82Khmd98XDHoVtIrGhWVU25XTOLWd2V2gM6uaBONDjtD74_xt9pwtXp9eZg-LTDMq26ymYkqMlaAkk6IkRkJpQTFjDBhZcFUrqwUraVHUZiooCFJIQmg5zYWtoWYjdLPf3cbw2UFqq41LGppGeQhdqnLJmeCyoLxHb_eojiGlCLbaRrdRcVflpPo1XP0ZrvaGe_zqsNzVGzBH-N8n-wESvHq2</recordid><startdate>20180701</startdate><enddate>20180701</enddate><creator>Perdreau, E</creator><creator>Tsang, V</creator><creator>Hughes, M L</creator><creator>Ibrahim, M</creator><creator>Kataria, S</creator><creator>Janagarajan, K</creator><creator>Iriart, X</creator><creator>Khambadkone, S</creator><creator>Marek, J</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20180701</creationdate><title>Change in biventricular function after cone reconstruction of Ebstein's anomaly: an echocardiographic study</title><author>Perdreau, E ; Tsang, V ; Hughes, M L ; Ibrahim, M ; Kataria, S ; Janagarajan, K ; Iriart, X ; Khambadkone, S ; Marek, J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c329t-b2670df9ea939680d9e8fea3ddded954abafc638255bd762e60590028716fbeb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Cardiac Surgical Procedures - adverse effects</topic><topic>Cardiac Surgical Procedures - methods</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Cohort Studies</topic><topic>Ebstein Anomaly - diagnostic imaging</topic><topic>Ebstein Anomaly - surgery</topic><topic>Echocardiography - methods</topic><topic>Female</topic><topic>Humans</topic><topic>Image Interpretation, Computer-Assisted</topic><topic>Infant</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Observer Variation</topic><topic>Postoperative Complications - diagnostic imaging</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - physiopathology</topic><topic>Prognosis</topic><topic>Reference Values</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Treatment Outcome</topic><topic>Tricuspid Valve Insufficiency - diagnostic imaging</topic><topic>Tricuspid Valve Insufficiency - prevention & control</topic><topic>Ventricular Dysfunction, Right - diagnostic imaging</topic><topic>Ventricular Dysfunction, Right - etiology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Perdreau, E</creatorcontrib><creatorcontrib>Tsang, V</creatorcontrib><creatorcontrib>Hughes, M L</creatorcontrib><creatorcontrib>Ibrahim, M</creatorcontrib><creatorcontrib>Kataria, S</creatorcontrib><creatorcontrib>Janagarajan, K</creatorcontrib><creatorcontrib>Iriart, X</creatorcontrib><creatorcontrib>Khambadkone, S</creatorcontrib><creatorcontrib>Marek, J</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European heart journal cardiovascular imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Perdreau, E</au><au>Tsang, V</au><au>Hughes, M L</au><au>Ibrahim, M</au><au>Kataria, S</au><au>Janagarajan, K</au><au>Iriart, X</au><au>Khambadkone, S</au><au>Marek, J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Change in biventricular function after cone reconstruction of Ebstein's anomaly: an echocardiographic study</atitle><jtitle>European heart journal cardiovascular imaging</jtitle><addtitle>Eur Heart J Cardiovasc Imaging</addtitle><date>2018-07-01</date><risdate>2018</risdate><volume>19</volume><issue>7</issue><spage>808</spage><epage>815</epage><pages>808-815</pages><issn>2047-2404</issn><eissn>2047-2412</eissn><abstract>The Cone reconstruction in Ebstein's anomaly (EA) aims to reduce tricuspid valve regurgitation (TR) and reposition the valve to the anatomic annulus, but post-operative progress of ventricular function is poorly understood. This study evaluated biventricular function after Cone reconstruction using echocardiographic techniques.
A retrospective study assessing longitudinal change was conducted from 2009 to 2014. All symptomatic patients with EA and severe TR undergoing surgery were included. Transthoracic advanced echocardiography was performed pre- and post-operatively (at short-term (<30 days) and mid-term). Conventional and longitudinal 2D strain parameters were measured for left ventricle (LV) and right ventricle (RV). Paired analyses were compared using Wilcoxon Matched-pairs signed rank test. From the 38 patients operated for EA, the echocardiographic data of 17 patients, aged 15 (1-57 years) at operation could be analysed. Median follow up was 6 months (8 days-54 months). The tricuspid annular plane systolic excursion (26.42 ± 5.79 mm vs. 8.75 ± 3.18 mm, P < 0.001), RV fractional area change (FAC) (45.00 ± 8.13% vs. 35.46 ± 5.76%, P = 0.038) and LV 2D peak systolic strain were significantly reduced post-operatively (-20.49 ± 2.79 vs. -17.73 ± 2.76, P = 0.041), with a trend to later recovery for LV 2D strain. There was no evidence of systolic mechanical dys-synchrony before or after operation.
Although clinical outcome of Cone reconstruction for EA remains excellent, acute post-operative changes leads to reduction of myocardial function of both ventricles, with a trend to later recovery for LV. Continuing impairment of RV function is multifactorial but may reflect intrinsic myocardial deficiency.</abstract><cop>England</cop><pmid>28950308</pmid><doi>10.1093/ehjci/jex186</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Cardiac Surgical Procedures - adverse effects Cardiac Surgical Procedures - methods Child Child, Preschool Cohort Studies Ebstein Anomaly - diagnostic imaging Ebstein Anomaly - surgery Echocardiography - methods Female Humans Image Interpretation, Computer-Assisted Infant Male Middle Aged Observer Variation Postoperative Complications - diagnostic imaging Postoperative Complications - epidemiology Postoperative Complications - physiopathology Prognosis Reference Values Retrospective Studies Risk Assessment Treatment Outcome Tricuspid Valve Insufficiency - diagnostic imaging Tricuspid Valve Insufficiency - prevention & control Ventricular Dysfunction, Right - diagnostic imaging Ventricular Dysfunction, Right - etiology Young Adult |
| title | Change in biventricular function after cone reconstruction of Ebstein's anomaly: an echocardiographic study |
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