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Noninvasive Determination of Vortex Formation Time Using Transesophageal Echocardiography During Cardiac Surgery
Published on: November 28, 2018
Serial assessment of left ventricular diastolic function after Fontan procedure
Y F Cheung1, D J Penny, A N Redington
1Great Ormond Street Hospital for Children NHS Trust and Institute of Child Health, University of London WC1N 3JH, UK.
Heart (British Cardiac Society)
|March 18, 2000
Summary
Systemic ventricular diastolic function remains abnormal long after the Fontan procedure. Longitudinal changes suggest reduced left ventricular compliance and persistent relaxation abnormalities in Fontan patients.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Physiology
- Congenital Heart Disease
Background:
- The Fontan procedure is a palliative surgery for complex single-ventricle congenital heart defects.
- Long-term outcomes and physiological changes after the Fontan procedure require ongoing investigation.
Purpose of the Study:
- To evaluate longitudinal changes in systemic ventricular diastolic function in patients after the Fontan procedure.
- To characterize the progression of diastolic dysfunction over time.
Main Methods:
- Prospective study involving 13 patients assessed at two time points post-Fontan procedure (early and late).
- Doppler echocardiography with simultaneous ECG, phonocardiogram, and respirometer used for diastolic function assessment.
- Analysis included isovolumic relaxation time (IVRT), E wave deceleration time, and E:A velocity ratio.
Main Results:
- Patients exhibited prolonged IVRT and reduced E wave deceleration time, E and A wave velocities, and E:A velocity ratio compared to normal values.
- IVRT z scores significantly decreased, indicating improved relaxation over time, but remained abnormal.
- Prevalence of diastolic flow during isovolumic relaxation decreased, while mid-diastolic flow increased, suggesting altered diastolic filling patterns.
Conclusions:
- Left ventricular diastolic function remains significantly abnormal late after the Fontan procedure.
- Longitudinal changes indicate a reduction in left ventricular compliance alongside persistent relaxation abnormalities.
- These findings highlight the chronic impact of the Fontan circulation on ventricular mechanics.
