Is there any role for computed tomography imaging in anticipating the functional status in adults late after total cavopulmonary connection? A retrospective evaluation.
Journal
Kardiologia polska
ISSN: 1897-4279
Titre abrégé: Kardiol Pol
Pays: Poland
ID NLM: 0376352
Informations de publication
Date de publication:
22 Nov 2019
22 Nov 2019
Historique:
pubmed:
5
10
2019
medline:
5
6
2020
entrez:
5
10
2019
Statut:
ppublish
Résumé
The Fontan procedure is performed in patients with congenital heart diseases and abnormal anatomy of the heart, which preclude intracardiac repair involving a separation of the systemic and pulmonary circulations. The role of computed tomography (CT) in assessing patients' clinical status after the total cavopulmonary connection (TCPC) procedure is not well defined. To determine a potential role and diagnostic capability of CT in the functional assessment of adults with the TCPC. Data obtained from 18 patients (10 women; mean [SD] age, 27.9 [6.3] years) with the TCPC were analyzed retrospectively. All patients underwent biochemical evaluation, cardiopulmonary exercise test, transthoracic echocardiography, and CT. Upon CT examination, the dimensions of the left and right pulmonary arteries, superior and inferior venae cavae, all pulmonary veins, and extracardiac conduits were measured. The measurements acquired by CT were correlated with the results of transthoracic echocardiography, cardiopulmonary exercise test, and biochemical analysis. The mean (SD) time after the TCPC was 18.5 (6.5) years. The area and circumference of the inferior vena cava significantly correlated with age (r = 0.503, P <0.05). A significant positive correlation was found between the area and circumference of a conduit and the predicted maximal oxygen uptake (r = 0.664, P <0.01). The area (β = 0.746, R2 = 0.556, P <0.01) and the circumference (β = 0.757, R2 = 0.572, P <0.01) of a conduit were considered significant predictors in estimating the value of maximal oxygen uptake. Our study showed an association between the dimensions of an extracardiac conduit and patient functional status, time elapsed since the procedure, and age of adults who underwent the TCPC in childhood. These findings support a more extensive use of CT in patients with TCPC, complemented by the measurements of the superior and inferior venae cavae and the conduit.
Sections du résumé
BACKGROUND
The Fontan procedure is performed in patients with congenital heart diseases and abnormal anatomy of the heart, which preclude intracardiac repair involving a separation of the systemic and pulmonary circulations. The role of computed tomography (CT) in assessing patients' clinical status after the total cavopulmonary connection (TCPC) procedure is not well defined.
AIMS
To determine a potential role and diagnostic capability of CT in the functional assessment of adults with the TCPC.
METHODS
Data obtained from 18 patients (10 women; mean [SD] age, 27.9 [6.3] years) with the TCPC were analyzed retrospectively. All patients underwent biochemical evaluation, cardiopulmonary exercise test, transthoracic echocardiography, and CT. Upon CT examination, the dimensions of the left and right pulmonary arteries, superior and inferior venae cavae, all pulmonary veins, and extracardiac conduits were measured. The measurements acquired by CT were correlated with the results of transthoracic echocardiography, cardiopulmonary exercise test, and biochemical analysis.
RESULTS
The mean (SD) time after the TCPC was 18.5 (6.5) years. The area and circumference of the inferior vena cava significantly correlated with age (r = 0.503, P <0.05). A significant positive correlation was found between the area and circumference of a conduit and the predicted maximal oxygen uptake (r = 0.664, P <0.01). The area (β = 0.746, R2 = 0.556, P <0.01) and the circumference (β = 0.757, R2 = 0.572, P <0.01) of a conduit were considered significant predictors in estimating the value of maximal oxygen uptake.
CONCLUSIONS
Our study showed an association between the dimensions of an extracardiac conduit and patient functional status, time elapsed since the procedure, and age of adults who underwent the TCPC in childhood. These findings support a more extensive use of CT in patients with TCPC, complemented by the measurements of the superior and inferior venae cavae and the conduit.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM