Faculty Advisor or Committee Member

Dalin Tang, Advisor

Faculty Advisor or Committee Member

Dalin Tang

Co-advisor

Tal Geva

Identifier

etd-082714-140848

Abstract

"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. "

Publisher

Worcester Polytechnic Institute

Degree Name

PhD

Department

Mathematical Sciences

Project Type

Dissertation

Date Accepted

2014-08-27

Accessibility

Unrestricted

Subjects

RVEF, PVR, Shape Analysis, ToF

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