Limited Ventricular Preload is the Main Reason for Reduced Stress Reserve After Atrial Baffle Repair

Eicken, Andreas; Michel, Julia; Hager, Alfred; Tanase, Daniel; Kaemmerer, Harald; Cleuziou, Julie; Hess, John; Ewert, Peter

doi:10.1007/s00246-016-1521-5

Cited by 10 publications

(5 citation statements)

References 25 publications

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“…Recent investigations have shown a preserved inotropic state 5 . In addition, impaired ventricular filling following inflow correction has been documented 6,7 .…”

Section: Discussionmentioning

confidence: 99%

Characterization of morphology and function of the ‘neo-atria’ after a modified Mustard operation

Nagy

Hosny

Sawy

et al. 2021

gcsp

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Background: There is a pressing need to improve early and long-term results of the Mustard operation. A modification of the operation was introduced at the Aswan Heart Centre for this purpose which relies on creating new functional atria rather than the two rigid channels in the classical Mustard operation.Objectives: To evaluate the morphology and function of the neo-atria, shortly after modified mustard operation for a ‘neglected’ patient with TGA, VSD and severe pulmonary hypertension.Methods: A 6-year-old with neglected TGA, VSD and pulmonary hypertension presented with severe cyanosis, clubbing and haemoconcentration (Hb 22 g/dL), underwent the modified Aswan-Mustard operation (MAM) with rapid smooth postoperative recovery. Repeated 2D echograms and multi-slice CT scans, followed by 3D segmentation, were performed after the operation. The size, shape, and morphology of the neo-atria were measured and measurements of the patterns of instantaneous filling and emptying of the right and left ventricles were quantified.Results: The neo-systemic venous atrium consisted of three components with a combined volume of 78 mL/m2, all of which contributed to the reservoir, conduit, and importantly contractile function of the neo-atrium. The pulmonary venous atrium consisted of two components with a combined volume of 66 mL/m2. These measurements were made at atrial end diastole. The volumes of the systemic venous and the pulmonary venous diminished to 51 and 54 mL/m2, respectively, at the end atrial systole - indicating relatively preserved contractile functions.

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“…Recent investigations have shown a preserved inotropic state 5 . In addition, impaired ventricular filling following inflow correction has been documented 6,7 .…”

Section: Discussionmentioning

confidence: 99%

Characterization of morphology and function of the ‘neo-atria’ after a modified Mustard operation

Nagy

Hosny

Sawy

et al. 2021

gcsp

View full text Add to dashboard Cite

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“…This could be a major limitation of the parameter, especially in patients with TGA after atrial switch procedure, in whom significant filling abnormalities through surgical baffles may exist. 23,24 Assessment of the SAVVR is also a crucial component of the echocardiographic evaluation of patients with sRV, as it has been shown to interplay with sRV dysfunction. 10 In TGA patients, SAVVR is attributed to annular dilatation and sRV dysfunction; therefore, replacement of the SAVV is usually not required.…”

Section: Namentioning

confidence: 99%

“…Another disadvantage is that the method is not valid with irregular rates, such as atrial fibrillation and elevated atrial pressure. This could be a major limitation of the parameter, especially in patients with TGA after atrial switch procedure, in whom significant filling abnormalities through surgical baffles may exist 23,24 …”

Section: Echocardiographymentioning

confidence: 99%

Multi‐modality imaging of the systemic right ventricle in congenital heart disease

Baroutidou,

Ntiloudi,

Kasinos

et al. 2024

Echocardiography

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A comprehensive and structured imaging approach in the evaluation of the systemic right ventricle (sRV) in patients with complete transposition of the great arteries (TGA) after atrial switch procedure and congenitally corrected transposition of the great arteries (ccTGA) is a key for their optimal lifelong surveillance. Despite the improvements in cardiovascular imaging of adults with congenital heart disease (ACHD), the imaging of sRV remains an ongoing challenge due to its complex morphology and the difficulty in applying the existing knowledge for the systemic left ventricle. While cardiac magnetic resonance (CMR) is considered the gold standard imaging method, echocardiographic evaluation is primarily preferred in everyday clinical setting. Although qualitative assessment of its systolic function is primarily used, the introduction of advanced echocardiographic techniques, such as speckle tracking echocardiography (STE) and three‐dimensional echocardiography (3DE), has provided new insights into the optimal assessment of the sRV. Standardized quantitative parameters remain to be elucidated, and morphometric and mechanistic studies are warranted to validate reference ranges for the sRV. This review highlights the challenges in the optimal evaluation of sRV and summarizes the available imaging tools.Highlights CMR is the gold standard imaging method of sRV. Qualitative assessment of the systolic function of sRV is primarily used. Advanced echocardiographic techniques (STE and 3DE) provide optimal sRV assessment. Reference ranges for the sRV indices are warranted to be validated.

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“…often stiff and non-contractile) will abnormally impact inflow characteristics. Thus, although important, standard inflow diastolic parameters generally remain non-applicable [ 25 , 26 ].…”

Section: Specific Considerations When Interpreting the Congenital Ech...mentioning

confidence: 99%

A practical guideline for performing a comprehensive transthoracic echocardiogram in the congenital heart disease patient: consensus recommendations from the British Society of Echocardiography

et al. 2022

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Transthoracic echocardiography is an essential tool in the diagnosis, assessment, and management of paediatric and adult populations with suspected or confirmed congenital heart disease. Congenital echocardiography is highly operator-dependent, requiring advanced technical acquisition and interpretative skill levels. This document is designed to complement previous congenital echocardiography literature by providing detailed practical echocardiography imaging guidance on sequential segmental analysis, and is intended for implementation predominantly, but not exclusively, within adult congenital heart disease settings. It encompasses the recommended dataset to be performed and is structured in the preferred order for a complete anatomical and functional sequential segmental congenital echocardiogram. It is recommended that this level of study be performed at least once on all patients being assessed by a specialist congenital cardiology service. This document will be supplemented by a series of practical pathology specific congenital echocardiography guidelines. Collectively, these will provide structure and standardisation to image acquisition and reporting, to ensure that all important information is collected and interpreted appropriately.

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Limited Ventricular Preload is the Main Reason for Reduced Stress Reserve After Atrial Baffle Repair

Cited by 10 publications

References 25 publications

Characterization of morphology and function of the ‘neo-atria’ after a modified Mustard operation

Characterization of morphology and function of the ‘neo-atria’ after a modified Mustard operation

Multi‐modality imaging of the systemic right ventricle in congenital heart disease

A practical guideline for performing a comprehensive transthoracic echocardiogram in the congenital heart disease patient: consensus recommendations from the British Society of Echocardiography

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