PMID- 33739388
OWN - NLM
STAT- MEDLINE
DCOM- 20211015
LR  - 20211015
IS  - 1873-734X (Electronic)
IS  - 1010-7940 (Linking)
VI  - 60
IP  - 3
DP  - 2021 Sep 11
TI  - The reduced left ventricular stroke volume does not fully recover after pulmonary 
      valve replacement in patients with repaired tetralogy of Fallot.
PG  - 526-533
LID - 10.1093/ejcts/ezab112 [doi]
AB  - OBJECTIVES: The present study was conducted to investigate the decrease in left 
      ventricular stroke volume index (LVSVI) that is caused by pulmonary 
      regurgitation-induced right heart dysfunction and its clinical implications 
      before and after pulmonary valve replacement (PVR). METHODS: Between January 2010 
      and December 2019, 30 adults who underwent surgical PVR for chronic pulmonary 
      regurgitation with right ventricular dilation late after tetralogy of Fallot 
      (TOF) repair were included. All patients were evaluated using cardiac magnetic 
      resonance before PVR. The median interval from TOF repair to PVR was 29 [25th, 
      75th percentile: 25, 37] years. The median pulmonary regurgitation fraction and 
      right ventricular end-diastolic volume index were 56 [48, 66] % and 203 [187, 
      239] ml/m2. Twenty-three patients (76.7%) were re-evaluated 1 year after PVR. 
      RESULTS: Before PVR, the median LVSVI was 40 [35, 46] ml/beat/m2. A lower LVSVI 
      was associated with a longer interval from TOF repair to PVR (r = -0.40, 
      P = 0.029) and a lower right ventricular ejection fraction (r = 0.52, P = 0.004). 
      A lower LVSVI was not associated with a higher right ventricular end-diastolic 
      volume index. LVSVI remained unchanged after PVR. The patients were subdivided 
      into Normal-stroke volume index (SVI) and Subnormal-SVI groups using the 
      preoperative LVSVI cut-off value of 35 mL/beat/m2. Compared with the Normal-SVI 
      group, the Subnormal-SVI group had a higher incidence of ablation therapy before 
      PVR (4.7 vs 2.3 patient-years, P = 0.044). After PVR, LVSVI in the Subnormal-SVI 
      group was still lower (40 [34, 42] vs 44 [42, 47] ml/beat/m2, P = 0.038) despite 
      the right ventricular end-diastolic volume index normalization. There was no 
      difference in the clinical event incidence between the 2 groups during the 
      follow-up period. Brain natriuretic peptide level in the Subnormal-SVI group was 
      higher within 3 years after PVR (P = 0.046). CONCLUSIONS: Reduced left 
      ventricular stroke volume did not fully recover after PVR. PVR for patients with 
      repaired TOF should be performed before the left ventricular stroke volume begins 
      to decrease.
CI  - (c) The Author(s) 2021. Published by Oxford University Press on behalf of the 
      European Association for Cardio-Thoracic Surgery. All rights reserved.
FAU - Yasukawa, Takashi
AU  - Yasukawa T
AUID- ORCID: 0000-0002-1616-067X
AD  - Department of Pediatric Cardiovascular Surgery, National Cerebral and 
      Cadiovascular Center, Suita, Japan.
FAU - Hoashi, Takaya
AU  - Hoashi T
AUID- ORCID: 0000-0003-0320-3682
AD  - Department of Pediatric Cardiovascular Surgery, National Cerebral and 
      Cadiovascular Center, Suita, Japan.
FAU - Imai, Kenta
AU  - Imai K
AD  - Department of Pediatric Cardiovascular Surgery, National Cerebral and 
      Cadiovascular Center, Suita, Japan.
FAU - Okuda, Naoki
AU  - Okuda N
AD  - Department of Pediatric Cardiovascular Surgery, National Cerebral and 
      Cadiovascular Center, Suita, Japan.
FAU - Fukuda, Tetsuya
AU  - Fukuda T
AD  - Department of Radiology, National Cerebral and Cardiovascular Center, Suita, 
      Japan.
FAU - Ohuchi, Hideo
AU  - Ohuchi H
AD  - Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, 
      Suita, Japan.
FAU - Kurosaki, Kenichi
AU  - Kurosaki K
AD  - Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, 
      Suita, Japan.
FAU - Ichikawa, Hajime
AU  - Ichikawa H
AD  - Department of Pediatric Cardiovascular Surgery, National Cerebral and 
      Cadiovascular Center, Suita, Japan.
LA  - eng
PT  - Journal Article
PL  - Germany
TA  - Eur J Cardiothorac Surg
JT  - European journal of cardio-thoracic surgery : official journal of the European 
      Association for Cardio-thoracic Surgery
JID - 8804069
SB  - IM
MH  - Adult
MH  - *Heart Valve Prosthesis Implantation/adverse effects
MH  - Humans
MH  - *Pulmonary Valve/diagnostic imaging/surgery
MH  - *Pulmonary Valve Insufficiency/diagnostic imaging/etiology/surgery
MH  - Stroke Volume
MH  - *Tetralogy of Fallot/diagnostic imaging/surgery
MH  - Treatment Outcome
MH  - Ventricular Function, Right
OTO - NOTNLM
OT  - Left ventricular function
OT  - Left ventricular stroke volume
OT  - Pulmonary valve replacement
OT  - Tetralogy of Fallot
EDAT- 2021/03/20 06:00
MHDA- 2021/10/16 06:00
CRDT- 2021/03/19 12:23
PHST- 2020/09/14 00:00 [received]
PHST- 2021/01/18 00:00 [revised]
PHST- 2021/01/31 00:00 [accepted]
PHST- 2021/03/20 06:00 [pubmed]
PHST- 2021/10/16 06:00 [medline]
PHST- 2021/03/19 12:23 [entrez]
AID - 6178646 [pii]
AID - 10.1093/ejcts/ezab112 [doi]
PST - ppublish
SO  - Eur J Cardiothorac Surg. 2021 Sep 11;60(3):526-533. doi: 10.1093/ejcts/ezab112.