Related Experiment Video
Updated: Feb 3, 2026
Reduction in Left Ventricular Wall Stress and Improvement in Function in Failing Hearts using Algisyl-LVR
Published on: April 8, 2013
Computed Tomography-Based Ventricular Volumes and Morphometric Parameters for Deciding the Treatment Strategy in
Hyun Woo Goo1, Sang-Hyub Park1
1Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea.
Insights
Computed tomography (CT) imaging provides key ventricular volumes and morphometric parameters to guide treatment decisions for children with hypoplastic left ventricle (LV). These CT-derived metrics can help identify patients suitable for single ventricle repair (SVR).
Area of Science:
- Pediatric Cardiology
- Medical Imaging
- Congenital Heart Disease
Background:
- Hypoplastic left ventricle (LV) is a severe congenital heart defect requiring complex treatment strategies.
- Accurate assessment of LV size and morphology is crucial for determining the optimal surgical approach, such as single ventricle repair (SVR) or biventricular repair (BVR).
- Computed tomography (CT) offers detailed anatomical visualization, but its utility in guiding treatment for hypoplastic LV is not fully established.
Purpose of the Study:
- To evaluate the effectiveness of CT-derived ventricular volumes and morphometric parameters in guiding treatment strategies for pediatric patients with hypoplastic LV.
- To identify specific CT imaging criteria that can differentiate patients who are candidates for SVR from those who are not.
- To establish cut-off values for CT parameters to aid in surgical decision-making for hypoplastic LV.
Main Methods:
- Ninety-four children with hypoplastic LV were analyzed, categorized into small LV SVR, small LV BVR, disease-matched control, and control groups.
- CT scans were used to measure indexed LV volumes (end-systolic and end-diastolic), LV-to-right-ventricular (LV/RV) volume ratio, and atrioventricular valve (AVV) dimensions.
- Statistical comparisons were made between groups to identify significant differences in these parameters and to determine predictive cut-off values for SVR.
Main Results:
- Significantly smaller indexed LV end-systolic and end-diastolic volumes were observed in the small LV SVR group compared to control groups (p < 0.001).
- Specific CT-derived cut-off values for indexed LV volumes (< 7 mL/m² ES, < 17 mL/m² ED), LV/RV volume ratio (< 0.22), AVV area ratio (< 0.33), and AVV diameter ratio (< 0.52) effectively differentiated patients suitable for SVR.
- One patient undergoing BVR had a fatal outcome, suggesting that pre-operative CT parameters might have indicated a poorer prognosis for this approach.
Conclusions:
- CT-based ventricular volumes and morphometric parameters are valuable tools for establishing cut-off values to guide SVR decisions in children with hypoplastic LV.
- These quantitative CT measurements can improve the accuracy of treatment strategy selection, potentially optimizing outcomes.
- Further research may refine these CT criteria for even more precise surgical planning in complex pediatric heart conditions.
Objective:
To determine the utility of computed tomography (CT) ventricular volumes and morphometric parameters for deciding the treatment strategy in children with a hypoplastic left ventricle (LV).
Materials And Methods:
Ninety-four consecutive children were included in this study and divided into small LV single ventricle repair (SVR) (n = 28), small LV biventricular repair (BVR) (n = 6), disease-matched control (n = 19), and control (n = 41) groups. The CT-based indexed LV volumes, LV-to-right-ventricular (LV/RV) volume ratio, left-to-right atrioventricular valve (AVV) area ratio, left-to-right AVV diameter ratio, and LV/RV long dimension ratio were compared between groups. Proportions of preferred SVR in the small LV SVR group suggested by the parameters were evaluated.
Results:
Indexed LV end-systolic (ES) and end-diastolic (ED) volumes in the small LV SVR group (6.3 ± 4.0 mL/m2 and 14.4 ± 10.2 mL/m2, respectively) were significantly smaller than those in the disease-matched control group (16.0 ± 4.7 mL/m2 and 37.7 ± 12.0 mL/m2, respectively; p < 0.001) and the control group (16.0 ± 5.5 mL/m2 and 46.3 ± 10.8 mL/m2, respectively; p < 0.001). These volumes were 8.3 ± 2.4 mL/m2 and 21.4 ± 5.3 mL/m2, respectively, in the small LV BVR group. ES and ED indexed LV volumes of < 7 mL/m2 and < 17 mL/m2, LV/RV volume ratios of < 0.22 and < 0.25, AVV area ratios of < 0.33 and < 0.24, and AVV diameter ratios of < 0.52 and < 0.46, respectively, enabled the differentiation of a subset of patients in the small LV SVR group from those in the two control groups. One patient in the small LV biventricular group died after BVR, indicating that this patient might not have been a good candidate based on the suggested cut-off values.
Conclusion:
CT-based ventricular volumes and morphometric parameters can suggest cut-off values for SVR in children with a hypoplastic LV.
Related Concept Videos
01:10Computed Tomography
The technique was invented in the 1970s and is based on the principle that as X-rays pass through the body, they are absorbed or reflected at different levels. In the technique, a patient lies on a motorized platform while a computerized axial tomography (CAT) scanner rotates...
01:27Imaging Studies III: Computed Tomography
01:24Treatment Strategies for Psychological Disorders
Psychological therapies focus on modifying emotions, thoughts, and behaviors through talking, interpreting, listening, rewarding, challenging, and modeling. Clinical psychologists, counselors, and social workers commonly practice psychotherapy. Clinical...
01:18Anatomy of the Brain: Ventricles
01:23Design Example: Deciding Thickness of Lubricating Fluid in a Shaft
To calculate the required thickness of the lubricant layer, the tangential velocity at the shaft's surface must first be determined. This velocity is calculated by converting the rotational speed to angular velocity...
01:10Wave Parameters