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Preserved Regional Atrial Contractile Function Following Extra-atrial Rather Than Intra-atrial Type Fontan Operation: a Tissue Doppler Imaging Study

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Date 2007 Feb 13
PMID 17294346
Citations 2
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Abstract

Objective: To determine the univentricular and atrial function in patients following Fontan operation using tissue Doppler echocardiography (TDE).

Setting: Hospital-based outpatient clinic and inpatient unit.

Patients: Thirty-six patients (mean age 13 ys [2-34 ys]) after Fontan procedure and 30 healthy individuals matched for age and heart rate.

Main Outcome Measures: Pulsed wave Doppler derived Tei index was determined for global univentricular function. Tissue-Doppler derived strain rate and strain were measured for regional ventricular function. Different planimetric approaches were used to evaluate the global atrial function. Strain rate was measured for regional atrial contractile function.

Results: The Tei index, reflecting global univentricular function, was significantly higher in Fontan patients than in the control group (p<0.001). The regional ventricular contractile function, which was determined by TDE derived strain and strain rate, was significantly lower in Fontan patients than in healthy controls (p<0.001). The global atrial function evaluated planimetrically, and the regional atrial function assessed using the TDE strain rate, were significantly lower in Fontan patients than in normal controls (p<0.001, p<0.001, respectively). A comparison of different types of Fontan operations with extra-atrial or intra-atrial baffle showed a better regional left atrial wall strain rate in patients with extra-atrial baffle than with intra-atrial baffle.

Conclusion: Patients who have undergone the Fontan procedure may present with altered ventricular and atrial performance independent of whether the extra-atrial or intraatrial type Fontan operation was performed. However, the regional atrial contractile function seems to be better preserved following the extra-atrial type Fontan operation.

Citing Articles

Evaluation of Regional Myocardial Function by Strain and Strain Rate before and after Surgical Repair of Congenital Heart Anomalies.

Rafieyian S, Roodpeyma S, Vahidshahi K, Moghadasi A J Tehran Heart Cent. 2018; 13(1):18-23.

PMID: 29997666 PMC: 6037632.


Use of tissue Doppler imaging to identify and manage systemic diseases.

Weidemann F, Strotmann J Clin Res Cardiol. 2007; 97(2):65-73.

PMID: 17713717 DOI: 10.1007/s00392-007-0566-0.

References
1.
Wong T, Davlouros P, Li W, Millington-Sanders C, Francis D, Gatzoulis M . Mechano-electrical interaction late after Fontan operation: relation between P-wave duration and dispersion, right atrial size, and atrial arrhythmias. Circulation. 2004; 109(19):2319-25. DOI: 10.1161/01.CIR.0000129766.18065.DC. View

2.
Vitarelli A, Conde Y, Cimino E, DAngeli I, DOrazio S, Ventriglia F . Quantitative assessment of systolic and diastolic ventricular function with tissue Doppler imaging after Fontan type of operation. Int J Cardiol. 2005; 102(1):61-9. DOI: 10.1016/j.ijcard.2004.04.008. View

3.
Penny D, Rigby M, Redington A . Abnormal patterns of intraventricular flow and diastolic filling after the Fontan operation: evidence for incoordinate ventricular wall motion. Br Heart J. 1991; 66(5):375-8. PMC: 1024779. DOI: 10.1136/hrt.66.5.375. View

4.
Akagi T, Benson L, Williams W, Freedom R . Regional ventricular wall motion abnormalities in tricuspid atresia after the Fontan procedure. J Am Coll Cardiol. 1993; 22(4):1182-8. DOI: 10.1016/0735-1097(93)90435-4. View

5.
Kurotobi S, Sano T, Naito H, Matsushita T, Takeuchi M, Kogaki S . Regional ventricular systolic abnormalities caused by a rudimentary chamber in patients with univentricular hearts. Am J Cardiol. 1998; 82(1):86-92. DOI: 10.1016/s0002-9149(98)00244-6. View