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Echocardiographic analysis of ventricular geometry and function during repair of congenital septal defects. Ann Thorac Surg 2004 Jan;77(1):53-60

Date

01/17/2004

Pubmed ID

14726034

DOI

10.1016/s0003-4975(03)01328-6

Scopus ID

2-s2.0-9144250170   17 Citations

Abstract

BACKGROUND: This study investigated changes in left ventricular (LV) geometry and systolic function after corrective surgery for atrial (ASD) and ventricular septal defects (VSD).

METHODS: Transesophageal LV short-axis echocardiograms were recorded before and after operative repair of ASD (n = 11) and VSD (n = 7). Preload was measured using LV end-diastolic area indexed for body surface area. Measurements of septal-freewall (D1) and anterior-posterior (D2) endocardial diameters were used to assess LV symmetry from D1/D2. Systolic indices included stroke area, area ejection fraction, and fractional shortening.

RESULTS: Preload, stroke area, area ejection fraction, and fractional shortening of D1 increased after ASD repair but decreased after VSD repair (p < 0.05). End-diastolic symmetry increased after ASD closure and decreased after VSD closure (p < 0.05). Increases in stroke area and ejection fraction after ASD correction primarily reflected increased shortening of D1. A positive correlation was found overall between percent change in end-diastolic area (EDA) and percent change in area ejection fraction (r(2) = 0.80, p < 0.0001, n = 18).

CONCLUSIONS: Preload was the primary determinant of changes in LV function in this series of ASD and VSD repairs. Intraoperative changes in position of the interventricular septum affected systolic and diastolic LV symmetry and septal free wall shortening. Additional studies are needed to define changes in afterload and contractility as well as diastolic compliance and systolic mechanics.

Author List

Hart JP, Cabreriza SE, Walsh RF, Printz BF, Blumenthal BF, Park DK, Zhu AJ, Gallup CG, Weinberg AD, Hsu DT, Mosca RS, Quaegebeur JM, Spotnitz HM

Author

Joseph Hart MD Associate Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Child
Child, Preschool
Heart Defects, Congenital
Humans
Infant
Intraoperative Care
Ultrasonography