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Pre and postoperative ventricular function in infants and children with right ventricular volume overload
Circulation
|March 1, 1977
Summary
Infants with total anomalous pulmonary venous return (TAPVR) often have abnormal ventricular volumes and reduced ejection fraction, leading to cardiorespiratory symptoms. Early surgical intervention is recommended for these patients.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Disease
- Echocardiography
Background:
- Total anomalous pulmonary venous return (TAPVR) and secundum atrial septal defect (ASD) are congenital heart conditions affecting ventricular function.
- Ventricular volume and hemodynamic parameters are crucial for assessing cardiac health in pediatric patients.
- Understanding the impact of these defects on right and left ventricular function is essential for effective management.
Purpose of the Study:
- To evaluate hemodynamic and ventricular volume parameters in patients with TAPVR and ASD.
- To assess the impact of surgical correction on these parameters.
- To identify the relationship between ventricular dysfunction and cardiorespiratory symptoms in infants with TAPVR.
Main Methods:
- Echocardiography was used to calculate right and left ventricular (RV and LV) volume parameters.
- Simpson's rule and area-length methods were employed for volume calculations.
- Patient cohorts included those with TAPVR, ASD, and post-correction of either condition.
Main Results:
- Infants with TAPVR exhibited larger RV end-diastolic volume and reduced RV ejection fraction.
- LV end-diastolic volume and LV ejection fraction were diminished in infants with TAPVR, irrespective of pulmonary hypertension.
- Preoperative RV end-diastolic volume and output were elevated in children with TAPVR or ASD, normalizing post-surgery.
Conclusions:
- Pulmonary venous obstruction and/or RV failure contribute to cardiorespiratory symptoms in infants with TAPVR.
- Early surgical intervention is advised for infants diagnosed with TAPVR.
- Postoperative normalization of RV parameters suggests the effectiveness of surgical correction for TAPVR and ASD.
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