Left ventricular function in infants and children with symptomatic Ebstein's anomaly

Hurwitz, Roger A.

doi:10.1016/0002-9149(94)90945-8

Cited by 25 publications

(11 citation statements)

References 9 publications

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“…10 In clinical practice, it is the duty of the echocardiographer to delineate the precise anatomy and functional state of both the myocardium and the malformed valvar complex in these patients, as both have important influences on management and outcome. [11][12][13][14][15]…”

Section: September 2006mentioning

confidence: 99%

Anatomy and echocardiography of the normal and abnormal tricuspid valve

2006

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Perhaps because it guards the inlet to the lesser circulation, the morphologically tricuspid valve has received less attention in terms of its anatomy than the well-explored mitral valve, which will receive attention in a subsequent review in this supplement.1 As we will show in our initial review, nonetheless, the approach to morphological analysis is the same for both valves, irrespective of whether the specific morphology is displayed in the autopsy room or the echocardiographic laboratory. It is essential that the valve be analysed so as to reveal the precise structure of each if its components – the so-called valvar complex.2 Equally important, in the current era, with the burgeoning use of three-dimensional displays that place the heart firmly within the context of the body, it is essential that the components of the valve be described as seen relative to the bodily axis,3 rather than following the present custom of describing the heart as though it is removed from the body and positioned on its own apex.

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Section: September 2006mentioning

confidence: 99%

Anatomy and echocardiography of the normal and abnormal tricuspid valve

2006

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“…R ight ventricular volume overload (RVVO) is often associated with tricuspid regurgitation [1][2][3][4][5][6][7] or a left-to-right shunt at the atrial level. 8 -11 Long-lasting RVVO gradually induces right ventricular (RV) and right atrial dilatation, leading to congestive RV failure.…”

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confidence: 99%

Total Right Ventricular Exclusion Improves Left Ventricular Function in Patients With End-Stage Congestive Right Ventricular Failure

et al. 2003

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Background-We developed a total right ventricular (RV) exclusion procedure for the treatment of isolated congestive RV failure. The objective of the present study was to elucidate the effects of a complete removal of RV volume overload (RVVO) on the surgically created single left ventricle (LV). Methods and Results-Three adults (2 arrhythmogenic RV dysplasia, 1 Ebstein) and 5 children (all Ebstein) in NYHA class IV underwent the procedure. The RV free wall was resected from the heart, and the tricuspid orifice was closed. Pulmonary blood supply was obtained by a cavopulmonary connection in 6 patients and a systemic-pulmonary shunt in 2. The LV function was evaluated by 2-dimensional echocardiography 1 month after the surgery. All patients are alive. The paradoxical movement of the interventricular septum and geometry of the LV expressed by its eccentricity (2.

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“…This result suggests the possible role of a small left ventricle in decreased exercise tolerance. Furthermore, the left ventricular function may be abnormal in Ebstein's anomaly [3,11]. Some patients have paradoxical septal motion of the atrialized right ventricle with alterations in left geometry and function [3], and right and left ventricular functions are intimately coupled in Ebstein's anomaly.…”

Section: Discussionmentioning

confidence: 99%

Cardiorespiratory Exercise Tolerance in Asymptomatic Children with Ebstein's Anomaly

Lupoglazoff

Denjoy

et al. 1999

Pediatr Cardiol

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The aim of the study was to evaluate cardiorespiratory exercise tolerance in asymptomatic children with Ebstein's anomaly. Eleven children with a mean age of 9.6 years were prospectively studied by spirometry, cardiopulmonary exercise testing (bicycle ergometer n = 8, treadmill test n = 3), and contrast echocardiography. A right-to-left atrial shunt was detected by contrast echocardiography in 7 children (group 1), whereas no shunt was found in 4 (group 2). VO2 max was decreased [84.5 (SD = 16.8)] and was strongly correlated to oxygen saturation in group 1 (p< 0.0001). Oxygen saturation at peak uptake was significantly decreased compared to baseline [97.4 (SD = 2.0) vs 90% (SD = 9.5%), p = 0.02] and was significantly lower in group 1 than in group 2 [85.7 (2.2) vs 98.2% (SD = 1.2%), p = 0. 03]. Oxygen desaturation was related to a right-to-left atrial shunt (p = 0.01). Decreased VO2 max was also correlated to the small size of the left ventricle (p = 0.05). We concluded that decreased exercise tolerance in children with asymptomatic Ebstein's anomaly is related to a right-to-left atrial shunt and to a small left ventricle. In case of poor exercise tolerance, a contrast echocardiography should be performed to detect an atrial septal defect.

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Left ventricular function in infants and children with symptomatic Ebstein's anomaly

Cited by 25 publications

References 9 publications

Anatomy and echocardiography of the normal and abnormal tricuspid valve

Anatomy and echocardiography of the normal and abnormal tricuspid valve

Total Right Ventricular Exclusion Improves Left Ventricular Function in Patients With End-Stage Congestive Right Ventricular Failure

Cardiorespiratory Exercise Tolerance in Asymptomatic Children with Ebstein's Anomaly

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