Hong Meng, Lin-Yuan Wan, Ran Qu, Qian-Qian Liu, Mu-Zi Li, Ye-Dan Li, Shi-Wei Pan, Shou-Jun Li, Qiang Wang, Jun Yan, Ke-Ming Yang
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引用次数: 0
摘要
背景:我们旨在利用超声心动图技术研究爱博斯坦畸形(EbA)手术矫正后的双心室重塑和功能,尤其是双心室变化与EbA类型之间的关系:从2015年4月至2022年8月,110名EbA患者被纳入这项基于Carpentier分类的回顾性研究。在术前、术后早期和中期进行超声心动图评估:结果:54 名 A 型和 B 型 EbA 患者被列入第一组,56 名 C 型和 D 型 EbA 患者被列入第二组。手术时的中位年龄为 8.8 岁。在中期随访期间,只有9.1%的患者存在中度或重度三尖瓣反流。第2组患者出院时右心室收缩功能有所恶化(分数面积变化:27.6±11.2对35.4±11.5[基线],PC结论:手术矫正 EbA 的成功率很高,瓣膜的耐用性令人鼓舞。大多数 A 型和 B 型患者的双心室收缩功能在术后都得到了很好的维持。在 C 型和 D 型患者中,术后发现 RV 收缩功能在最初下降后出现了后期的上升,而 LV 收缩功能则保持不变。
Biventricular function after Ebstein anomaly repair from a single-center echocardiography study.
Objective: We aimed to examine biventricular remodeling and function after Ebstein anomaly (EbA) surgical correction using echocardiographic techniques, particularly, the relations between the biventricular changes and the EbA types.
Methods: From April 2015 to August 2022, 110 patients with EbA were included in this retrospective study based on the Carpentier classification. Echocardiography assessments during the preoperative, early, and mid-term postoperative periods were performed.
Results: The 54 patients with types A and B EbA were included in group 1, whereas the 56 patients with types C and D were in group 2. Seventy-eight patients underwent surgical correction of EbA. The median age at operation was 8.8 years. During the mid-term follow-up, only 9.1% of the patients had moderate or severe tricuspid regurgitation. Right ventricular (RV) systolic function worsened in group 2 at discharge (fractional area change: 27.6 ± 11.2 vs. 35.4 ± 11.5 [baseline], P < 0.05; global longitudinal strain: -10.8 ± 4.4 vs. -17.9 ± 4.7 [baseline], P = 0.0001). RV function slowly recovered at a mean of 12 months of follow-up. Regarding left ventricular (LV) and RV systolic function, no statistical difference was found between before and after surgery in group 1.
Conclusion: A high success rate of surgical correction of EbA, with an encouraging durability of the valve, was noted. Biventricular systolic function was maintained fairly in most patients with types A and B postoperatively. A late increase in RV systolic function after an initial reduction and unchanged LV systolic function were observed in the patients with types C and D postoperatively.
期刊介绍:
The Hellenic Journal of Cardiology (International Edition, ISSN 1109-9666) is the official journal of the Hellenic Society of Cardiology and aims to publish high-quality articles on all aspects of cardiovascular medicine. A primary goal is to publish in each issue a number of original articles related to clinical and basic research. Many of these will be accompanied by invited editorial comments.
Hot topics, such as molecular cardiology, and innovative cardiac imaging and electrophysiological mapping techniques, will appear frequently in the journal in the form of invited expert articles or special reports. The Editorial Committee also attaches great importance to subjects related to continuing medical education, the implementation of guidelines and cost effectiveness in cardiology.