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[Left ventricular function in children after successful repair of aortic coarctation]
Norma A Balderrábano-Saucedo1, Alfredo Vizcaíno-Alarcón, Lorenzo Reyes-de la Cruz
1Departamento de Cardiología, Hospital Infantil de México Federico Gómez, México DF, Mexico. balderrabano_6@yahoo.es
Insights
Successful repair of aortic coarctation does not guarantee normal left ventricular function. Nearly half of patients show abnormal myocardial performance index, indicating potential long-term issues.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Cardiac Surgery
Background:
- Aortic coarctation repair is crucial for long-term survival.
- Late complications can impact prognosis after successful aortic coarctation repair.
- Assessing long-term left ventricular function is vital in these patients.
Purpose of the Study:
- To evaluate left ventricular (LV) function post-successful aortic coarctation repair.
- To identify predictors of abnormal LV function in repaired aortic coarctation patients.
Main Methods:
- Retrospective analysis of echocardiographic data from 40 patients post-aortic coarctation repair.
- Comparison of pre-repair and post-repair LV function parameters.
- Inclusion criteria: pressure gradient ≤15 mmHg and normal systemic blood pressure post-repair.
Main Results:
- Ejection fraction and shortening fraction improved in most patients (82.5% and 67.5%).
- Myocardial performance index (MPI) was abnormal in 47.5% of patients.
- Higher MPI correlated with hypertension at diagnosis, older age at repair (>4 years), and pre-existing LV abnormalities.
Conclusions:
- Global LV function remains abnormal in a significant portion of patients after successful aortic coarctation repair, as indicated by MPI.
- MPI is a sensitive indicator of subclinical LV dysfunction.
- Factors like hypertension, age at repair, and baseline LV status influence post-repair LV function.
Introduction And Objectives:
Lifetime prognosis following successful repair of aortic coarctation can be affected by a number of late complications. The objective of this study was to assess left ventricular function in these patients and to identify factors that predispose to functional abnormalities.
Methods:
The study involved patients who had undergone repair of aortic coarctation and who had a pressure gradient pound 15 mmHg after repair and normal systemic blood pressure. Echocardiographic data collected before repair and the results of the most recent postoperative left ventricular function studies were analyzed.
Results:
The study involved 40 patients and 31 controls. Their mean age at repair was 6.9 years and the mean follow-up period was 4.25 years. During follow-up, the ejection fraction and the shortening fraction were observed to increase in 82.5% and 67.5% of patients, respectively. The myocardial performance index was abnormal in 47.5% of patients. The highest myocardial performance indices were observed in patients with arterial hypertension at diagnosis, in those who were aged over 4 years when they underwent repair, and in those with the most abnormal left ventricles before repair.
Conclusions:
Measurement of the myocardial performance index showed that global left ventricular function was abnormal in 47.5% of patients after successful repair of aortic coarctation despite functional parameters being normal or elevated.
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