How is the peri-patch myocardium in ventricular septal defect patch repair?

Area of Science:

• Cardiology
• Biomedical Engineering
• Medical Imaging

Background:

• Tissue Doppler imaging provides noninvasive measurements of myocardial function.
• Strain rate (SR) and strain (≈) assess myocardial mechanics independent of heart motion.
• Ventricular septal defect (VSD) repair involves patch placement, potentially affecting regional myocardial function.

Purpose of the Study:

• To evaluate peri-patch regional myocardial function after VSD repair.
• To assess the extent of functional impairment in the myocardium surrounding VSD repair patches.
• To compare peri-patch myocardial function with remote myocardial regions.

Main Methods:

• Myocardial SR and ≈ were recorded using tissue Doppler imaging in 18 pediatric patients post-VSD repair.
• Measurements were taken from peri-patch myocardium and remote septum.
• The distance from the patch to the return of normal strain profile was quantified.

Main Results:

• Peri-patch myocardium exhibited significantly decreased peak longitudinal SR and delayed time to peak longitudinal SR compared to remote regions.
• Peak longitudinal and radial strain (≈) were reduced, and their time to peak was delayed in the peri-patch area.
• The mean distance from the patch to the normalization of the strain profile was 2.55 ± 0.77 mm.

Conclusions:

• Myocardium adjacent to VSD repair patches demonstrates delayed and diminished contraction.
• Regional myocardial function is significantly affected in the peri-patch area following VSD repair.
• These findings highlight the importance of assessing peri-patch myocardial mechanics after VSD surgery.