Related Experiment Video

Updated: Aug 12, 2026

Morphological and Functional Assessment of the Right Ventricle Using 3D Echocardiography
07:11

Morphological and Functional Assessment of the Right Ventricle Using 3D Echocardiography

Published on: October 28, 2020

Right Ventricular Diastolic Function Predicts Adverse Outcomes After Pulmonary Valve Replacement in Patients With

Takashi Kido1, Yosuke Kugo1, Motoki Komori1

  • 1Department of Cardiovascular Surgery, The University of Osaka Graduate School of Medicine Osaka Japan.

Circulation Reports
|August 11, 2026
PubMed

Insights

Pulmonary valve replacement (PVR) timing in repaired tetralogy of Fallot (TOF) is crucial. Right ventricular diastolic dysfunction significantly impacts outcomes, and age over 35 is a risk factor only in these patients.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Congenital Heart Disease

Background:

  • Pulmonary valve replacement (PVR) timing in repaired tetralogy of Fallot (TOF) is debated.
  • Right ventricular (RV) diastolic dysfunction's role in post-PVR outcomes needs clarification.
  • Investigating age as a universal risk factor for adverse outcomes after PVR.

Purpose of the Study:

  • To examine the influence of RV diastolic dysfunction on post-PVR outcomes in repaired TOF patients.
  • To determine if age ≥35 years at PVR universally predicts adverse outcomes or is subgroup-specific.

Main Methods:

  • Retrospective review of 81 patients undergoing PVR for repaired TOF (2002-2022).
  • Defined adverse outcomes: arrhythmia treatment or heart failure hospitalization.
  • Defined RV diastolic dysfunction: RV end-diastolic pressure ≥12 mmHg and/or RA volume index ≥83 mL/m².
  • Used Cox regression and subgroup analyses.

Main Results:

  • Adverse outcomes occurred in 30% of patients.
  • Right atrial (RA) volume index was the sole independent predictor of adverse outcomes.
  • Age ≥35 years at PVR was linked to adverse events only in patients with RV diastolic dysfunction.

Conclusions:

  • RV diastolic dysfunction is significantly associated with adverse post-PVR clinical outcomes.
  • Advanced age (≥35 years) at PVR is a risk factor only in patients with RV diastolic dysfunction, not universally.
  • Patient-specific factors like RV diastolic dysfunction are critical for PVR timing decisions.
Abstract

Keywords:
Pulmonary valve replacementRight atrial volumeRight ventricular diastolic functionTetralogy of Fallot

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