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Open Access Evaluation of Left Ventricular Systolic Function after Pulmonary Valve Replacement Using Cardiovascular Magnetic Resonance Imaging

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This article is Open Access under the terms of the Creative Commons CC BY-NC licence.

Following reparative surgery for tetralogy of Fallot or critical pulmonary stenosis (PS), patients frequently present with severe right ventricular (RV) volume overload due to pulmonary regurgitation, resulting in decreased RV function. Surgical pulmonary valve replacement (PVR) is known to improve RV function, but changes in left ventricular (LV) function after PVR have rarely been described. We sought to determine the midterm results regarding LV systolic function after PVR using cardiac MRI in 40 consecutive patients with repaired TOF (31 patients) or PS (9 patients) with an age of 29±9 years who underwent PVR from 2006 to 2011 at a single center. Cardiac MRI RV and LV volumes before and after PVR were analyzed. Demographics, clinical variables, cardiopulmonary bypass duration, and medications were reviewed. LV ejection fraction (LVEF) increased from (54±8) to (57±6)% (P=0.02). Before PVR, 26 patients had depressed LVEF of (49±5)% (range 36‐54%). In this group, LVEF increased by (7±7)% (P<0.0001) after PVR. Low LVEF before PVR was correlated with increased LVEF after PVR (regression coefficient −0.7, R 2=0.59, P<0.0001). Demographics, medications, prior pregnancies, and cardiopulmonary bypass duration had no effect on LVEF after PVR. The increase in LVEF was most significant in patients with low pre-PVR LVEF.
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Keywords: cardiovascular magnetic resonance imaging; left ventricular ejection fraction; pulmonary valve replacement; tetralogy of Fallot

Document Type: Research Article

Publication date: 01 May 2018

This article was made available online on 09 May 2018 as a Fast Track article with title: "Evaluation of Left Ventricular Systolic Function after Pulmonary Valve Replacement Using Cardiovascular Magnetic Resonance Imaging".

More about this publication?
  • Cardiovascular Innovations and Applications (CVIA) publishes focused articles and original clinical research that explore novel developments in cardiovascular disease, effective control and rehabilitation in cardiovascular disease, and promote cardiovascular innovations and applications for the betterment of public health globally. The journal publishes basic research that has clinical applicability in order to promote timely communication of the latest insights relating to coronary artery disease, heart failure, hypertension, cardiac arrhythmia, prevention of cardiovascular disease with a heavy emphasis on risk factor modification. Cardiovascular Innovations and Applications is the official journal of the Great Wall International Congress of Cardiology (GW-ICC). It aims to continue the work of the GW-ICC by providing a global scientific communication platform for cardiologists that bridges East and West.

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