Abstract 15254: Echocardiographic Variables Immediately Post Right Ventricular Decompression Predict Right Ventricular Growth and Biventricular Circulation in Patients With Pulmonary Atresia Intact Ventricular Septum
Background: Neonates with pulmonary atresia-intact ventricular septum (PA-IVS) who undergo right ventricular (RV) decompression ultimately have two-ventricle (2V) or <2V circulation depending on RV size. We sought to determine the relation between post-decompression echocardiographic parameters, RV growth and 2V circulation.
Methods: Neonates undergoing RV decompression for PA-IVS from 2005-2015 at the 4 member centers of the Congenital Catheterization Research Collaborative were included. Echocardiograms at baseline, first post-decompression, and follow up closest to 1 year post decompression were analyzed. The primary outcomes were RV growth by echocardiogram and 2V circulation.
Results: Of the 81 patients in the study, 11 (14%) had <2V circulation, and 54 (67%) had follow up echocardiograms available. After decompression, tricuspid regurgitation (TR) and RV function improved (Table 1). Post-decompression ≥moderate TR and higher pulmonary valve antegrade velocity were associated with 2V circulation (Table 2). Baseline tricuspid valve z score correlated with larger increase in RV area/BSA (R=0.42, p = 0.005). Patients with ≥moderate TR post decompression had an increase in RV area of 22.3 (7.6-29.7) cc/m2 vs 14.3 (6.8-19.3) cc/m2 in those with ≤mild TR (p = 0.049). Those with bidirectional flow at the ASD post-decompression had an increase in RV area of 24.2(14.3-26.6) cc/m2 vs 9.8 (6.8-15.5) cc/m2 in those with right to left flow (p=0.007).
Conclusions: Post-decompression tricuspid regurgitation severity and bidirectional ASD flow post-decompression appear to be associated with RV growth and 2V circulation in patients with PA-IVS following RV decompression
Author Disclosures: S.A. Maskatia: None. C.D. Tavers: None. D.J. Goldberg: None. L.S. Rogers: None. A.C. Glatz: None. A.M. Qureshi: None. B.H. Goldstein: None. C.J. Petit: None. J. Ao: None. R. Sachdeva: None.
- © 2016 by American Heart Association, Inc.