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Tytuł pozycji:

Cardiovascular Magnetic Resonance Findings Late After the Arterial Switch Operation.

Tytuł :
Cardiovascular Magnetic Resonance Findings Late After the Arterial Switch Operation.
Autorzy :
Shepard CW; From the The Children's Heart Clinic, Minneapolis, MN (C.W.S.); Department of Pediatrics, University of Crete, Greece (I.G.); Department of Cardiology, Boston Children's Hospital, MA; and Department of Pediatrics, Harvard Medical School, Boston, MA (M.T.W., A.J.P., T.G.); Division of Pediatric Cardiology, University of Florida, Gainesville (J.C.-V.).
Germanakis I; From the The Children's Heart Clinic, Minneapolis, MN (C.W.S.); Department of Pediatrics, University of Crete, Greece (I.G.); Department of Cardiology, Boston Children's Hospital, MA; and Department of Pediatrics, Harvard Medical School, Boston, MA (M.T.W., A.J.P., T.G.); Division of Pediatric Cardiology, University of Florida, Gainesville (J.C.-V.).
White MT; From the The Children's Heart Clinic, Minneapolis, MN (C.W.S.); Department of Pediatrics, University of Crete, Greece (I.G.); Department of Cardiology, Boston Children's Hospital, MA; and Department of Pediatrics, Harvard Medical School, Boston, MA (M.T.W., A.J.P., T.G.); Division of Pediatric Cardiology, University of Florida, Gainesville (J.C.-V.).
Powell AJ; From the The Children's Heart Clinic, Minneapolis, MN (C.W.S.); Department of Pediatrics, University of Crete, Greece (I.G.); Department of Cardiology, Boston Children's Hospital, MA; and Department of Pediatrics, Harvard Medical School, Boston, MA (M.T.W., A.J.P., T.G.); Division of Pediatric Cardiology, University of Florida, Gainesville (J.C.-V.).
Co-Vu J; From the The Children's Heart Clinic, Minneapolis, MN (C.W.S.); Department of Pediatrics, University of Crete, Greece (I.G.); Department of Cardiology, Boston Children's Hospital, MA; and Department of Pediatrics, Harvard Medical School, Boston, MA (M.T.W., A.J.P., T.G.); Division of Pediatric Cardiology, University of Florida, Gainesville (J.C.-V.).
Geva T; From the The Children's Heart Clinic, Minneapolis, MN (C.W.S.); Department of Pediatrics, University of Crete, Greece (I.G.); Department of Cardiology, Boston Children's Hospital, MA; and Department of Pediatrics, Harvard Medical School, Boston, MA (M.T.W., A.J.P., T.G.); Division of Pediatric Cardiology, University of Florida, Gainesville (J.C.-V.). .
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Źródło :
Circulation. Cardiovascular imaging [Circ Cardiovasc Imaging] 2016 Sep; Vol. 9 (9).
Typ publikacji :
Journal Article; Research Support, Non-U.S. Gov't
Język :
English
Imprint Name(s) :
Original Publication: Hagerstown, MD Lippincott Williams & Wilkins
MeSH Terms :
Arterial Switch Operation*/adverse effects
Magnetic Resonance Angiography*
Magnetic Resonance Imaging, Cine*
Aortic Valve Insufficiency/*diagnostic imaging
Cicatrix/*diagnostic imaging
Hypertrophy, Left Ventricular/*diagnostic imaging
Hypertrophy, Right Ventricular/*diagnostic imaging
Transposition of Great Vessels/*surgery
Ventricular Dysfunction, Left/*diagnostic imaging
Adolescent ; Adult ; Aorta/diagnostic imaging ; Aortic Valve Insufficiency/etiology ; Aortic Valve Insufficiency/physiopathology ; Boston ; Child ; Child, Preschool ; Cicatrix/etiology ; Cicatrix/pathology ; Contrast Media/administration & dosage ; Dilatation, Pathologic ; Female ; Fibrosis ; Gadolinium DTPA/administration & dosage ; Humans ; Hypertrophy, Left Ventricular/etiology ; Hypertrophy, Right Ventricular/etiology ; Infant ; Male ; Multivariate Analysis ; Myocardium/pathology ; Odds Ratio ; Predictive Value of Tests ; Retrospective Studies ; Risk Factors ; Time Factors ; Transposition of Great Vessels/complications ; Transposition of Great Vessels/diagnostic imaging ; Treatment Outcome ; Ventricular Dysfunction, Left/etiology ; Ventricular Dysfunction, Left/physiopathology ; Ventricular Function, Left ; Young Adult
Contributed Indexing :
Keywords: arterial switch operation*; magnetic resonance imaging*; regurgitation aortic valve*; transposition of great vessels*; valvular heart disease, congenital*; ventricular function*
Substance Nomenclature :
0 (Contrast Media)
K2I13DR72L (Gadolinium DTPA)
Entry Date(s) :
Date Created: 20160908 Date Completed: 20170509 Latest Revision: 20181026
Update Code :
20210210
DOI :
10.1161/CIRCIMAGING.116.004618
PMID :
27601366
Czasopismo naukowe
Background: Despite its robust diagnostic capabilities in adolescents and adult patients after the arterial switch operation, little information is available on the cardiovascular magnetic resonance findings in this population.
Methods and Results: The cardiovascular magnetic resonance findings of 220 consecutive patients evaluated in our center were retrospectively reviewed (median age at cardiovascular magnetic resonance, 15.4 years; 66.8% male sex). Compared with published normal values, left and right ventricular end-diastolic volume z scores were mildly enlarged (0.48±1.76 and 0.33±1.5; P=0.0003 and 0.0038, respectively), with 26% of patients having left ventricular dilatation and 20% having right ventricular dilatation. Left ventricular dysfunction was present in 21.5% of patients (mild in most), and only 5.1% of patients had mild right ventricular dysfunction. Myocardial scar was found in 1.8% of patients. Dilatation of the neoaortic root was common (76%), and root z score increased at an average rate of 0.03 points per year. By multivariable analysis, neoaortic root dilatation was associated with worse neoaortic valve regurgitation (OR, 5.29; P=0.0016). The diameters of the thoracic aorta distal to the root were near-normal in most patients, whereas the neomain pulmonary artery was typically oval shaped with decreased anteroposterior and normal lateral diameters.
Conclusions: Although the majority of arterial switch operation patients have normal ventricular size and function and myocardial scar is rare, an important minority exhibits ventricular enlargement or dysfunction. Neoaortic root dilatation, which is present in most patients and progresses over time, is strongly associated with significant neoaortic valve regurgitation. The findings of this study provide reference values against which arterial switch operation patients can be compared with their peers.
(© 2016 American Heart Association, Inc.)
Comment in: Circ Cardiovasc Imaging. 2016 Sep;9(9):. (PMID: 27601370)

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