کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
2948512 1577205 2012 8 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Acute and Chronic Effects of Dysfunction of Right Ventricular Outflow Tract Components on Right Ventricular Performance in a Porcine Model : Implications for Primary Repair of Tetralogy of Fallot
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی کاردیولوژی و پزشکی قلب و عروق
پیش نمایش صفحه اول مقاله
Acute and Chronic Effects of Dysfunction of Right Ventricular Outflow Tract Components on Right Ventricular Performance in a Porcine Model : Implications for Primary Repair of Tetralogy of Fallot
چکیده انگلیسی

ObjectivesThis study investigates the contribution of infundibular versus pulmonary valve (PV) dysfunction on right ventricular (RV) function in a porcine model.BackgroundClinical outcome after repair of tetralogy of Fallot is determined by the adaptation of the right ventricle to the physiological sequelae of the right ventricular outflow tract (RVOT) reconstruction. Recent surgical techniques are pursuing a PV-versus infundibulum-sparing approach.MethodsIn a porcine model, 3 types of RVOT dysfunction were created and compared with sham-operated controls: infundibular dysfunction (INF), PV insufficiency (PI), and combined infundibular–PV dysfunction (TAP). Both acute and chronic effects on RV function were studied by using conductance technology and magnetic resonance imaging.ResultsIn animals with PI, pulmonary regurgitant fraction progressed more in the presence of concomitant INF (54% in TAP versus 14% in PI; p = 0.03). Subsequently, RV end-systolic and end-diastolic volume increased more in both groups, resulting in decreased ejection fraction after 3 months. Preload-independent systolic indices showed acute impairment of RV contractility in all treatment groups but most in animals with infundibular scarring (INF and TAP). Further chronic deterioration was observed in animals of the TAP group. RV compliance improved proportionally most in the PI and TAP groups in relation to the extent of RV dilation.ConclusionsSurgical RVOT dysfunction, whether it includes the infundibulum and/or the PV, has an immediate effect on RV performance. Although impaired RV contractility is due to intrinsic myocardial damage by infundibular distortion, it is chronically furthered by PI-related RV dilation. These findings support the adoption of a RVOT-sparing strategy to treat tetralogy of Fallot.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of the American College of Cardiology - Volume 60, Issue 1, 3 July 2012, Pages 64–71
نویسندگان
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