Right Ventricle Curvature Maybe a Predictor for Pulmonary Valve Replacement Surgery Outcome: A Multi-Patient Study

Zuo, Heng

Etd

Right Ventricle Curvature Maybe a Predictor for Pulmonary Valve Replacement Surgery Outcome: A Multi-Patient Study

Public

Patients with repaired tetralogy of Fallot (TOF) account for the majority of cases with late onset right ventricle (RV) failure. The current surgical approach, which includes pulmonary valve replacement/insertion (PVR), has yielded mixed results in terms of RV functional recovery. Therefore, it is of great interest for clinicians to identify parameters, which may be used to predict post-PVR outcome. Pre- and post-PVR cardiac magnetic resonance (CMR) data were obtained from 60 repaired TOF patients with consent obtained for analysis. RV ejection fraction (RVEF) change (post-PVR RVEF minus pre-PVR RVEF) was used to measure post-PVR improvement. The patients were divided into Group 1(optimal outcome) and Group 2 (poor outcome) for comparison. RV wall thickness (WT) and curvature were obtained from CMR data for statistical analysis. Using mean quarter values (one CMR slice = 4 quarters), statistically significant differences in circumferential curvature (C-curvature) and longitudinal curvature (L-curvature) at end-diastole (maximum RV volume) and WT and C-curvature at end-systole (minimum RV volume) between Group 1 and Group 2 were found. Correlations between average WT at systole and between L-curvature at diastole and the change of RVEF were statistically significant. Specifically, the correlation coefficient between average WT at systole and change of RVEF was – 0.2715, (p = 0.036) and between L-curvature at diastole and change of RVEF 0.3297 (p = 0.01). This initial study suggests that the RV longitudinal curvature and wall thickness may be used as a marker/predictor for PVR surgical outcome.

Creator