Transthoracic echocardiography for right ventricular function late after the Mustard operation

Area of Science:

• Pediatric Cardiology
• Cardiac Imaging
• Congenital Heart Disease

Background:

• The Mustard baffle repair is a palliative surgical procedure for transposition of the great arteries (TGA).
• Long-term assessment of right ventricular (RV) function is crucial for patients with TGA post-Mustard repair.
• Echocardiography is a non-invasive imaging modality used for evaluating cardiac function.

Purpose of the Study:

• To evaluate echocardiographic measurements of RV function in young adults who underwent the Mustard repair.
• To correlate echocardiographic RV function parameters with radionuclide-based RV ejection fraction (RVEF).
• To establish the range of RV volumes and assess the reliability of echocardiographic RVEF prediction in this cohort.

Main Methods:

• The study included 24 patients (age 10.7-28.9 years) with Mustard repair for TGA.
• Echocardiographic parameters assessed included RVEF (single-plane, area-length), mean aortic acceleration, and tricuspid annular plane systolic excursion.
• These echocardiographic measures were correlated with first-pass radionuclide RVEF.

Main Results:

• Mean radionuclide RVEF was 39%. Mean echocardiographic RVEF (apical four-chamber) was 41%, and short-axis RVEF was 37%.
• Interobserver and intraobserver correlation coefficients for echocardiographic RVEF were 0.73 and 0.81, respectively.
• Correlation coefficients between radionuclide RVEF and echocardiographic methods were modest (e.g., short-axis: 0.40, apical four-chamber: 0.24).

Conclusions:

• Echocardiography can establish the range of RV volumes in young adults post-Mustard repair, aiding serial monitoring for dilatation.
• Simple and reliable echocardiographic prediction of RVEF in this specific patient group remains elusive.
• Further research may be needed to refine echocardiographic techniques for accurate RV function assessment in post- Mustard repair patients.