Computed Tomography for Evaluating Right Ventricle and Pulmonary Artery in Pediatric Tetralogy of Fallot: Correlation with Post-operative Pulmonary Regurgitation

Overview

Journal Sci Rep

Specialty Science

Date 2018 May 16

PMID 29760475

Citations 2

Authors

Yue Gao

Zhi-Gang Yang

Ke Shi

Kai-Yue Diao

Hua-Yan Xu

Ying-Kun Guo

Affiliations

Soon will be listed here.

Abstract

Pulmonary regurgitation (PR) is the most common complication after tetralogy of Fallot (TOF) surgical repair, and long-term PR might result in cardiovascular events. The aim of this study was to assess the influence of pre-operative right ventricle (RV) and pulmonary artery (PA) parameters assessed by dual-source computed tomography on post-operative PR. A total of 41 TOF patients who underwent trans-valve surgical repair were retrospectively recruited. The RV and PA parameters evaluated by pre-operative DSCT were compared between the PR and non-PR groups. Our result revealed that the PA parameters (McGoon ratio, Nakata index, and LPA diameter) and RV parameters (RV length diameter and RV short diameter) all showed significant differences between the two groups (all p < 0.05). There was a significant correlation between PR and LPA diameter (r = 0.361), McGoon ratio (r = 0.413), and Nakata index (r = 0.482). Receiver operating characteristic analysis also revealed a moderate sensitivity and specificity of LPA (66.33%; 82.60%), McGoon ratio (83.33%, 56.52%), and Nakata index (83.33%; 60.87%) for predicting the occurrence of PR. This study indicated that these pre-operative indices calculated by DSCT are associated with post-operative PR and that these pre-operative PA and RV parameters may serve as novel predictors of the risk of PR.

Citing Articles

The Nakata index and McGoon ratio: correlation with the severity of pulmonary regurgitation after the repair of paediatric tetralogy of Fallot.

Abbaszadeh R, Askari-Moghadam R, Moradian M, Mortazaeian H, Qomi M, Omidi N Egypt Heart J. 2023; 75(1):95.

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Acute Change in Ventricular Contractility-Load Coupling After Corrective Surgery for Congenital Heart Defect: A Retrospective Cohort Study.

Oh J, Song I, Cho J, Yun T, Park C, Choi J Pediatr Cardiol. 2019; 40(8):1618-1626.

PMID: 31482237 PMC: 6848039. DOI: 10.1007/s00246-019-02195-z.

References

Habib H, Jacobs J, Mavroudis C, Tchervenkov C, OBrien S, Mohammadi S . Contemporary patterns of management of tetralogy of Fallot: data from the Society of Thoracic Surgeons Database. Ann Thorac Surg. 2010; 90(3):813-9. DOI: 10.1016/j.athoracsur.2010.03.110. View

Voser E, Kellenberger C, Valsangiacomo Buechel E . Effects of pulmonary regurgitation on distensibility and flow of the branch pulmonary arteries in tetralogy of Fallot. Pediatr Cardiol. 2013; 34(5):1118-24. DOI: 10.1007/s00246-012-0616-x. View

Shi K, Gao H, Yang Z, Zhang Q, Liu X, Guo Y . Preoperative evaluation of coronary artery fistula using dual-source computed tomography. Int J Cardiol. 2016; 228:80-85. DOI: 10.1016/j.ijcard.2016.11.169. View

Kilner P, Balossino R, Dubini G, Babu-Narayan S, Taylor A, Pennati G . Pulmonary regurgitation: the effects of varying pulmonary artery compliance, and of increased resistance proximal or distal to the compliance. Int J Cardiol. 2008; 133(2):157-66. DOI: 10.1016/j.ijcard.2008.06.078. View

Lewis M, OConnor D, Rozenshtien A, Ye S, Einstein A, Ginns J . Usefulness of magnetic resonance imaging to guide referral for pulmonary valve replacement in repaired tetralogy of Fallot. Am J Cardiol. 2014; 114(9):1406-11. DOI: 10.1016/j.amjcard.2014.07.082. View

Chen J, Yang Z, Xu H, Shi K, Long Q, Guo Y . Assessments of pulmonary vein and left atrial anatomical variants in atrial fibrillation patients for catheter ablation with cardiac CT. Eur Radiol. 2016; 27(2):660-670. DOI: 10.1007/s00330-016-4411-6. View

Kato A, Drolet C, Yoo S, Redington A, Grosse-Wortmann L . Vicious circle between progressive right ventricular dilatation and pulmonary regurgitation in patients after tetralogy of Fallot repair? Right heart enlargement promotes flow reversal in the left pulmonary artery. J Cardiovasc Magn Reson. 2016; 18(1):34. PMC: 4897954. DOI: 10.1186/s12968-016-0254-1. View

Apitz C, Webb G, Redington A . Tetralogy of Fallot. Lancet. 2009; 374(9699):1462-71. DOI: 10.1016/S0140-6736(09)60657-7. View

Geva T . Repaired tetralogy of Fallot: the roles of cardiovascular magnetic resonance in evaluating pathophysiology and for pulmonary valve replacement decision support. J Cardiovasc Magn Reson. 2011; 13:9. PMC: 3036629. DOI: 10.1186/1532-429X-13-9. View

10.

Wald R, Valente A, Gauvreau K, Babu-Narayan S, Assenza G, Schreier J . Cardiac magnetic resonance markers of progressive RV dilation and dysfunction after tetralogy of Fallot repair. Heart. 2015; 101(21):1724-30. DOI: 10.1136/heartjnl-2015-308014. View

11.

Mercer-Rosa L, Yang W, Kutty S, Rychik J, Fogel M, Goldmuntz E . Quantifying pulmonary regurgitation and right ventricular function in surgically repaired tetralogy of Fallot: a comparative analysis of echocardiography and magnetic resonance imaging. Circ Cardiovasc Imaging. 2012; 5(5):637-43. PMC: 3476467. DOI: 10.1161/CIRCIMAGING.112.972588. View

12.

Villafane J, Feinstein J, Jenkins K, Vincent R, Walsh E, Dubin A . Hot topics in tetralogy of Fallot. J Am Coll Cardiol. 2013; 62(23):2155-66. DOI: 10.1016/j.jacc.2013.07.100. View

13.

Jing L, Haggerty C, Suever J, Alhadad S, Prakash A, Cecchin F . Patients with repaired tetralogy of Fallot suffer from intra- and inter-ventricular cardiac dyssynchrony: a cardiac magnetic resonance study. Eur Heart J Cardiovasc Imaging. 2014; 15(12):1333-43. PMC: 4432392. DOI: 10.1093/ehjci/jeu123. View

14.

Shi K, Yang Z, Chen J, Zhang G, Xu H, Guo Y . Assessment of Double Outlet Right Ventricle Associated with Multiple Malformations in Pediatric Patients Using Retrospective ECG-Gated Dual-Source Computed Tomography. PLoS One. 2015; 10(6):e0130987. PMC: 4482600. DOI: 10.1371/journal.pone.0130987. View

15.

Jing L, Wehner G, Suever J, Charnigo R, Alhadad S, Stearns E . Left and right ventricular dyssynchrony and strains from cardiovascular magnetic resonance feature tracking do not predict deterioration of ventricular function in patients with repaired tetralogy of Fallot. J Cardiovasc Magn Reson. 2016; 18(1):49. PMC: 4993000. DOI: 10.1186/s12968-016-0268-8. View

16.

Lee C, Kim Y, Lee C, Kwak J, Park C, Song J . Outcomes of pulmonary valve replacement in 170 patients with chronic pulmonary regurgitation after relief of right ventricular outflow tract obstruction: implications for optimal timing of pulmonary valve replacement. J Am Coll Cardiol. 2012; 60(11):1005-14. DOI: 10.1016/j.jacc.2012.03.077. View

17.

Warnes C, Williams R, Bashore T, Child J, Connolly H, Dearani J . ACC/AHA 2008 Guidelines for the Management of Adults with Congenital Heart Disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to develop guidelines on the.... Circulation. 2008; 118(23):e714-833. DOI: 10.1161/CIRCULATIONAHA.108.190690. View

18.

Krishnamurthy R, Pednekar A, Atweh L, Vogelius E, Chu Z, Zhang W . Clinical validation of free breathing respiratory triggered retrospectively cardiac gated cine balanced steady-state free precession cardiovascular magnetic resonance in sedated children. J Cardiovasc Magn Reson. 2015; 17(1):1. PMC: 4293107. DOI: 10.1186/s12968-014-0101-1. View

19.

Weinberg C, McElhinney D . Pulmonary valve replacement in tetralogy of Fallot. Circulation. 2014; 130(9):795-8. DOI: 10.1161/CIRCULATIONAHA.114.005551. View

20.

Rudski L, Lai W, Afilalo J, Hua L, Handschumacher M, Chandrasekaran K . Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology,.... J Am Soc Echocardiogr. 2010; 23(7):685-713. DOI: 10.1016/j.echo.2010.05.010. View