Abstract 16559: Right Ventricular Volume and Functional Change Following Surgical Pulmonary Valve Replacement in Adults With Congenital Heart Disease.
Purpose: To assess postoperative changes in right ventricular volumes and function in adults undergoing surgical pulmonary valve replacement (PVR) in the setting of previously treated congenital heart disease.
Methods: In a tertiary adult congenital cardiac centre 52 adults (29 male; age at operation: 30.8±2 (mean±SEM) underwent PVR with a bioprosthetic valve over a 25 month period. Only those with a preoperative echo that was suitable for off-line analysis of the right ventricle and alive at 30 days were included (n=41). The original clinical diagnosis was previously corrected Tetralogy of Fallot in 33, Pulmonary Stenosis in 9 and other in 10. The mean time since original right ventricular (RV) outflow tract repair was 24.8±1.7 years. Pulmonary regurgitation was the predominant lesion in 30 patients. Pre- and post procedure echocardiograms were analyzed to measure various parameters including: RV end diastolic area (RVEDA), RV end systolic area (RVESA), RV fractional area change (RVFAC), tricuspid annulus plane systolic excursion (TAPSE), RV tissue doppler imaging (TDI), and peak main pulmonary artery velocity (MPA).
Results: Results are displayed in Table 1.
Conclusions: This study demonstrates early and significant regression of right ventricular volumes following PVR. This effect is seen as early as 1 month and continuous benefit is seen at 3 months. RV function is significantly reduced after surgery as evidenced by reduced TAPSE and RVFAC followed by recovery after 3 months. Relevant RV parameters can be analyzed by echocardiography in the outpatient setting and provide an easily accessible and means for monitoring patient progress.
- © 2011 by American Heart Association, Inc.