Open Access
ARTICLE
A Ring-Reinforced Right Ventricle to Pulmonary Artery Conduit is Associated with Better Regional Mechanics after Stage I Norwood Operation
Benjamin Zielonka1,2,*, David M. Harrild1,2, Sunil J. Ghelani1,2, Eleni G. Elia1,2, Christopher W. Baird3,4, Andrew J. Powell1,2, Rahul H. Rathod1,2
1
Department of Cardiology, Boston Children’s Hospital, Boston, USA
2
Department of Pediatrics, Harvard Medical School, Boston, USA
3
Department of Cardiothoracic Surgery, Boston Children’s Hospital, Boston, USA
4
Department of Surgery, Harvard Medical School, Boston, USA
* Corresponding Author: Benjamin Zielonka. Email:
Congenital Heart Disease 2022, 17(5), 591-603. https://doi.org/10.32604/chd.2022.021509
Received 18 March 2022; Accepted 07 July 2022; Issue published 06 September 2022
Abstract
Background: The right ventricle to pulmonary artery conduit (RVPAC) may impair right ventricular (RV) function in patients with functional single right ventricles. Modification of the RVPAC using a ring-reinforced end
with dunked insertion into the RV through a limited ventriculotomy may reduce the impact on RV function.
We compared RV segmental strain between patients with a traditional RVPAC and ring-reinforced RVPAC using
feature tracking cardiovascular magnetic resonance (CMR) imaging.
Methods: Patients with CMR examinations
after Stage I operation with RVPAC between 2000 and 2018 were reviewed. Ventricular mass, volumes, late gadolinium enhancement (LGE), and peak radial and circumferential strain of the 4 segments near the RVPAC insertion site were analyzed.
Results: The study included 71 CMR examinations in 61 patients (30 traditional RVPAC,
31 ring-reinforced RVPAC). Prior to Stage II, the ring-reinforced RVPAC group had better peak radial strain and
circumferential strain in 1 of 4 segments proximal to the RVPAC insertion site compared to the traditional
RVPAC group. Prior to Stage III operation, the ring-reinforced group had better peak radial and circumferential
strain in 2 of 4 segments. LGE at the RVPAC insertion site was observed in 97% of patients before Stage II and
95% of patients before Stage III. RVPAC type and regional strain were not associated with transplant-free survival
during a median follow-up of 6.3 years.
Conclusions: Compared to a traditional RVPAC, the ring-reinforced
RVPAC is associated with improved regional mechanics at the conduit insertion site. Further investigation of
long-term outcomes after ring-reinforced RVPAC is warranted.
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APA Style
Zielonka, B., Harrild, D.M., Ghelani, S.J., Elia, E.G., Baird, C.W. et al. (2022). A ring-reinforced right ventricle to pulmonary artery conduit is associated with better regional mechanics after stage I norwood operation. Congenital Heart Disease, 17(5), 591-603. https://doi.org/10.32604/chd.2022.021509
Vancouver Style
Zielonka B, Harrild DM, Ghelani SJ, Elia EG, Baird CW, Powell AJ, et al. A ring-reinforced right ventricle to pulmonary artery conduit is associated with better regional mechanics after stage I norwood operation. Congeni Heart Dis. 2022;17(5):591-603 https://doi.org/10.32604/chd.2022.021509
IEEE Style
B. Zielonka et al., "A Ring-Reinforced Right Ventricle to Pulmonary Artery Conduit is Associated with Better Regional Mechanics after Stage I Norwood Operation," Congeni. Heart Dis., vol. 17, no. 5, pp. 591-603. 2022. https://doi.org/10.32604/chd.2022.021509