Pre and postoperative ventricular function in infants and children with right ventricular volume overload.

Abstract

Hemodynamic and ventricular volume parameters were evaluated in 21 patients (24 studies) with total anomalous pulmonary venous return (TAPVR), 11 patients with secundum atrial septal defect (ASD), and eight patients who had complete correction of TAPVR or ASD. Right and left ventricular (RV and LV) volume parameters were calculated according to Simpson's rule and the area length methods, respectively. In infants with TAPVR, RV end-diastolic volume was larger than normal, but RV ejection fraction was significantly less than normal. LV end-diastolic volume and LV ejection fraction were all less than normal in infants with or without pulmonary hypertension, and the values did not correlate with the cardiorespiratory symptoms. In children with TAPVR or ASD, RV end-diastolic volume and output were higher than normal preoperatively and decreased to normal or near normal values postoperatively. The data suggest that pulmonary venous obstruction and/or RV failure are responsible for cardiorespiratory symptoms in infants with TAPVR and early surgical intervention is recommended in these patients.

Serum Levels of Natriuretic Peptides in Children before and after Treatment for an Atrial Septal Defect, a Patent Ductus Arteriosus, and a Coarctation of the Aorta—A Prospective Study

“…Some studies have demonstrated that after closure of the defect, end-diastolic diameters and volumes of LV and RV change towards normal values [33, 34]. Similarly, in our patients, size of LV increased during follow-up, and no difference was present between patients and controls 6 months after treatment.…”

The outcome of the vertical vein left intact during the surgery for total anomalous venous connection and its effects on ventricular functions

“…In both of our studies, preoperative mean PA pressure values were significantly higher, whereas on the contrary, left ventricular area and volume values were lower in Group 1. This can be explained with the fact that majority of the patients in Group 1 had obstructive type anomalies (p<0.05), because presence of pulmonary venous hypertension causes increased right ventricle afterload, shifting of the septum towards left ventricle and finally underdeveloped left ventricular cavity (14,15). Mean age of patients at the time operation was also lower in Group 1, which may be another factor causing difference in sizes of the cardiac chambers between two groups.…”

The value of early repair for total anomalous pulmonary venous drainage

“…[17] and Nakazawa et al . [20] suggests : (a) preoperatively, the left ventricular size, ejection fraction, and systolic output are often decreased ; (b) these decreases probably result from a decreased volume load to the left ventricle ; (c) pulmonary symptoms result from venous obstruction and not from ventricular dysfunction ; and (d) decreased left ventricular size and function do not affect operative mortality and are reversed with early repair. These conclusions are supported by our current series .…”