Document Detail


Aortic root dysfunctioning and its effect on left ventricular function in Ross procedure patients assessed with magnetic resonance imaging.
MedLine Citation:
PMID:  17070172     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: This study evaluated the diameters and distensibility of the aortic root as well as the degree of aortic regurgitation (AR) and its effect on left ventricular (LV) function in patients 8.2 +/- 3.1 years after they underwent the Ross procedure, with a comparison of these parameters between patients and matched healthy subjects. METHODS: Eighteen Ross procedure patients (16 male patients, age [mean +/- SD] 19.2 +/- 3.8 years) and 18 matched healthy subjects (16 male patients, age [mean +/- SD] 19.7 +/- 4.2 years) underwent magnetic resonance imaging. Measurements for diameters (at 4 levels) and the distensibility of the aortic root were performed using a steady-state free precession sequence. Aortic flow was assessed with a velocity-encoded phase-contrast sequence. Left ventricular systolic function was assessed with a gradient-echo sequence in the short-axis plane. Comparison of parameters was performed using the Mann-Whitney U test. Correlations between diameters, distensibility, AR fraction, and LV systolic function were expressed with Spearman rank correlation coefficients. Linear regression analysis was used to identify predictors of LV systolic dysfunction. RESULTS: Aortic root diameters were increased in Ross procedure patients as compared with healthy subjects (mean difference 6.3-11.6 mm, P < or = .02 at all 4 levels). Distensibility of the aortic root was lower in patients (1.9 +/- 1.1 vs 7.8 +/- 3.3 mm Hg(-1), P < .01). An AR fraction > 5% was present in 14 of the 18 patients (mean AR fraction 8% +/- 5% vs 1% +/- 1%, P < .01). Left ventricular ejection fraction was lower in patients (50% +/- 6% vs 57% +/- 6%, P < .01). Dilatation, decreased distensibility, and AR fraction were correlated with impaired LV systolic function (P < .05 for all). The AR fraction predicted impaired LV systolic function (P < .01). CONCLUSIONS: Magnetic resonance imaging shows dilatation and decreased distensibility of the aortic root, AR, and consequent impaired LV systolic function in patients after the Ross procedure.
Authors:
Heynric B Grotenhuis; Jos J M Westenberg; Joost Doornbos; Lucia J M Kroft; Paul H Schoof; Mark G Hazekamp; Hubert W Vliegen; Jaap Ottenkamp; Albert de Roos
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American heart journal     Volume:  152     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2006 Nov 
Date Detail:
Created Date:  2006-10-30     Completed Date:  2006-11-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  975.e1-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Aorta / physiopathology*
Aortic Diseases / diagnosis,  etiology,  physiopathology*
Aortic Valve / surgery*
Cardiac Surgical Procedures / adverse effects*
Child
Dilatation, Pathologic
Female
Heart Valve Diseases / surgery
Humans
Magnetic Resonance Angiography
Male
Pulmonary Valve / surgery
Regional Blood Flow
Vasodilation
Ventricular Dysfunction, Left / diagnosis*,  etiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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