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Increased Aortic Stiffness and Left Ventricular Dysfunction Exist After Truncus Arteriosus Repair

Matthew L Stone1, Michal Schäfer2, Johannes C von Alvensleben2

  • 1Division of Pediatric Cardiothoracic Surgery, University of Colorado School of Medicine, Children's Hospital Colorado, Aurora, Colorado.

The Annals of Thoracic Surgery
|December 11, 2020
PubMed

Insights

Children with repaired truncus arteriosus (TA) show increased aortic stiffness and altered left ventricular (LV) function. These findings highlight the need for advanced cardiac magnetic resonance (CMR) assessments for long-term management.

Area of Science:

  • Pediatric Cardiology
  • Cardiovascular Imaging
  • Congenital Heart Disease

Background:

  • Truncus arteriosus (TA) repair in children can lead to long-term cardiovascular complications.
  • Assessing aortic biomechanical properties and left ventricular (LV) function is crucial post-TA repair.

Purpose of the Study:

  • To determine if aortic biomechanical properties are abnormal in children after repaired TA.
  • To evaluate LV function post-TA repair using a novel regional ventricular function platform.

Main Methods:

  • Cardiac magnetic resonance (CMR) imaging was used in 26 children post-TA repair and 20 controls.
  • Measured aortic stiffness (pulse wave velocity, relative area change) and LV function (volumes, ejection fraction, regional wall strain).

Main Results:

  • Children with repaired TA exhibited elevated ascending aortic pulse wave velocity and decreased relative area change.
  • Post-TA repair patients showed increased LV volumes, decreased regional wall strain, and mechanical dyssynchrony.
  • LV functional changes were not dependent on aortic biomechanical properties.

Conclusions:

  • Repaired TA in children is associated with increased aortic stiffness and altered LV function detected by CMR.
  • Longitudinal studies and advanced CMR are needed to predict late aortic complications and optimize patient management.
Abstract

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