Echocardiographic analysis of ventricular geometry and function during repair of congenital septal defects

Joseph P. Hart, Santos E. Cabreriza, Rowan F. Walsh, Beth F. Printz, Brianne F. Blumenthal, David K. Park, April J. Zhu, Cecily G. Gallup, Alan D. Weinberg, Daphne T. Hsu, Ralph S. Mosca, Jan M. Quaegebeur, Henry M. Spotnitz

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16 Scopus citations

Abstract

Background. This study investigated changes in left ventricular (LV) geometry and systolic function after corrective surgery for atrial (ASD) and ventricular septal defects (VSD). Methods. Transesophageal LV short-axis echocardiograms were recorded before and after operative repair of ASD (n = 11) and VSD (n = 7). Preload was measured using LV end-diastolic area indexed for body surface area. Measurements of septal-freewall (D1) and anterior-posterior (D2) endocardial diameters were used to assess LV symmetry from D1/D2. Systolic indices included stroke area, area ejection fraction, and fractional shortening. Results. Preload, stroke area, area ejection fraction, and fractional shortening of D1 increased after ASD repair but decreased after VSD repair (p < 0.05). End-diastolic symmetry increased after ASD closure and decreased after VSD closure (p < 0.05). Increases in stroke area and ejection fraction after ASD correction primarily reflected increased shortening of D1. A positive correlation was found overall between percent change in end-diastolic area (EDA) and percent change in area ejection fraction (r2 = 0.80, p < 0.0001, n = 18). Conclusions. Preload was the primary determinant of changes in LV function in this series of ASD and VSD repairs. Intraoperative changes in position of the interventricular septum affected systolic and diastolic LV symmetry and septal free wall shortening. Additional studies are needed to define changes in afterload and contractility as well as diastolic compliance and systolic mechanics.

Original languageEnglish (US)
Pages (from-to)53-60
Number of pages8
JournalAnnals of Thoracic Surgery
Volume77
Issue number1
DOIs
StatePublished - Jan 2004

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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    Hart, J. P., Cabreriza, S. E., Walsh, R. F., Printz, B. F., Blumenthal, B. F., Park, D. K., Zhu, A. J., Gallup, C. G., Weinberg, A. D., Hsu, D. T., Mosca, R. S., Quaegebeur, J. M., & Spotnitz, H. M. (2004). Echocardiographic analysis of ventricular geometry and function during repair of congenital septal defects. Annals of Thoracic Surgery, 77(1), 53-60. https://doi.org/10.1016/S0003-4975(03)01328-6