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Comparison of systemic right ventricular function in transposition of the great arteries after atrial switch and congenitally corrected transposition of the great arteries

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Abstract

In patients with transposition of the great arteries corrected by interatrial baffle (TGA) and those with congenitally corrected transposition of the great arteries (ccTGA) the right ventricle (RV) is subjected to systemic pressure and fails prematurely. Previous studies have demonstrated RV dysfunction may be more pronounced in patients with TGA. The present study sought to compare patients with TGA and ccTGA using three-dimensional (3D) techniques to comprehensively analyze the shape, volume, global and regional function in the systemic RV. We compared RV size, shape, and regional and global function in 25 patients with TGA, 17 patients with ccTGA, and 9 normal subjects. The RVs were reconstructed from cardiac Magnetic Resonance Images for 3D analyses. Compared to normal, the RV in TGA and ccTGA was dilated, rounded, and reduced in function. Compared to each other, TGA and ccTGA patients had similar RV size and shape. Global RV function was lower in TGA than ccTGA when assessed from ejection fraction (EF) (30 ± 7 vs. 35 ± 7, p = 0.02) and from normalized tricuspid annular systolic plane excursion (TAPSE) (0.10 ± 0.04 vs. 0.18 ± 0.04, p < 0.01). Basilar RV function was poorer in the TGA patients when compared to ccTGA. The systemic RVs in both TGA and ccTGA are dilated, spherical, and poorly functioning. Compared to ccTGA, TGA RVs have reduced TAPSE and worse basilar hypokinesis.

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Acknowledgements

The study was supported by the National Institutes of Health Research Cardiovascular Biomedical Research Unit at the Royal Brompton and Harefield NHS Foundation Trust and Imperial College, and by a grant from VentriPoint, Inc (Seattle, WA).

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Authors and Affiliations

  1. University of Washington, P. O. Box 356422, Seattle, WA, 98195-6422, USA

    Michael Morcos & Florence H. Sheehan

  2. Royal Brompton Hospital, London, UK

    Philip J. Kilner

  3. Oregon Health and Science University, Portland, OR, USA

    David J. Sahn

  4. University of Pennsylvania, Philadelphia, PA, USA

    Harold I. Litt

  5. Pediatric Heart Center University Children’s Hospital, Zurich, Switzerland

    Emanuela R. Valsangiacomo-Buechel

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  1. Michael Morcos
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  2. Philip J. Kilner
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  6. Florence H. Sheehan
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Correspondence to Michael Morcos.

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Conflict of interest

Dr. Sheehan is a founder and Chief Scientist of VentriPoint, Inc. and holds equity in the company. Dr. Philip Kilner’s participation was funded in part by the British Heart Foundation.

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Morcos, M., Kilner, P.J., Sahn, D.J. et al. Comparison of systemic right ventricular function in transposition of the great arteries after atrial switch and congenitally corrected transposition of the great arteries. Int J Cardiovasc Imaging 33, 1993–2001 (2017). https://doi.org/10.1007/s10554-017-1201-4

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  • DOI: https://doi.org/10.1007/s10554-017-1201-4

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