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

Research output: Contribution to journalArticle

15 Citations (Scopus)

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
Externally publishedYes

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Ventricular Function
Ventricular Heart Septal Defects
Stroke
Atrial Heart Septal Defects
Body Surface Area
Mechanics
Left Ventricular Function
Compliance

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Hart, J. P., Cabreriza, S. E., Walsh, R. F., Printz, B. F., Blumenthal, B. F., Park, D. K., ... 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

Echocardiographic analysis of ventricular geometry and function during repair of congenital septal defects. / Hart, Joseph P.; Cabreriza, Santos E.; Walsh, Rowan F.; Printz, Beth F.; Blumenthal, Brianne F.; Park, David K.; Zhu, April J.; Gallup, Cecily G.; Weinberg, Alan D.; Hsu, Daphne T.; Mosca, Ralph S.; Quaegebeur, Jan M.; Spotnitz, Henry M.

In: Annals of Thoracic Surgery, Vol. 77, No. 1, 01.2004, p. 53-60.

Research output: Contribution to journalArticle

Hart, JP, Cabreriza, SE, Walsh, RF, Printz, BF, Blumenthal, BF, Park, DK, Zhu, AJ, Gallup, CG, Weinberg, AD, Hsu, DT, Mosca, RS, Quaegebeur, JM & Spotnitz, HM 2004, 'Echocardiographic analysis of ventricular geometry and function during repair of congenital septal defects', Annals of Thoracic Surgery, vol. 77, no. 1, pp. 53-60. https://doi.org/10.1016/S0003-4975(03)01328-6
Hart, Joseph P. ; Cabreriza, Santos E. ; Walsh, Rowan F. ; Printz, Beth F. ; Blumenthal, Brianne F. ; Park, David K. ; Zhu, April J. ; Gallup, Cecily G. ; Weinberg, Alan D. ; Hsu, Daphne T. ; Mosca, Ralph S. ; Quaegebeur, Jan M. ; Spotnitz, Henry M. / Echocardiographic analysis of ventricular geometry and function during repair of congenital septal defects. In: Annals of Thoracic Surgery. 2004 ; Vol. 77, No. 1. pp. 53-60.
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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.",
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AU - Cabreriza, Santos E.

AU - Walsh, Rowan F.

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AU - Blumenthal, Brianne F.

AU - Park, David K.

AU - Zhu, April J.

AU - Gallup, Cecily G.

AU - Weinberg, Alan D.

AU - Hsu, Daphne T.

AU - Mosca, Ralph S.

AU - Quaegebeur, Jan M.

AU - Spotnitz, Henry M.

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N2 - 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.

AB - 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.

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