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Updated: Jul 2, 2026
08:21
Biventricular Assessment of Cardiac Function and Pressure-Volume Loops by Closed-Chest Catheterization in Mice
Published on: June 15, 2020
Ventricular function deteriorates with recurrent coarctation in hypoplastic left heart syndrome.
Luis Alesandro Larrazabal1, Elif Seda Selamet Tierney, David W Brown
1Department of Cardiac Surgery, Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts 02115, USA.
The Annals of Thoracic Surgery
|August 30, 2008
Summary
Recurrent coarctation after hypoplastic left heart syndrome (HLHS) stage I palliation negatively impacts right ventricular function. Early intervention for re-CoA improves RV systolic function, crucial for subsequent surgical stages.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Disease
- Cardiac Surgery
Background:
- Hypoplastic left heart syndrome (HLHS) requires staged palliation.
- Recurrent coarctation (re-CoA) is a known complication after stage I palliation.
- The impact of re-CoA on ventricular systolic function remains unclear.
Purpose of the Study:
- To investigate the effect of re-CoA on right ventricular systolic function after stage I palliation in HLHS patients.
- To assess the correlation between the severity of re-CoA and right ventricular fractional area change (RV-FAC).
- To evaluate the functional recovery of the right ventricle after intervention for re-CoA.
Main Methods:
- Retrospective review of HLHS patients undergoing stage I palliation and cavopulmonary shunt (CPS).
- Echocardiographic RV-FAC assessment at multiple time points (post-stage I, pre-CPS, pre-Fontan).
- Coarctation index (CI) calculation using cardiac catheterization/MRI data to define re-CoA.
Main Results:
- Twenty-one out of fifty-one patients had re-CoA (CI < 0.75).
- Lower CI values correlated with lower RV-FAC and a greater decrease in RV-FAC between stage I and pre-CPS.
- RV-FAC improved after balloon dilation for re-CoA, though not significantly different from controls at follow-up.
Conclusions:
- Recurrent aortic arch obstruction is associated with impaired RV systolic function prior to the stage II operation in HLHS.
- Timely intervention for re-CoA can lead to recovery of right ventricular function.
- Monitoring and early intervention for re-CoA are critical in HLHS management.
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