International Journal of Cardiology

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Date of download: 6/25/2016 Copyright © The American College of Cardiology. All rights reserved. From: Anatomically Oriented Right Ventricular Volume Measurements.

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Presentation transcript:

International Journal of Cardiology More than valve repair: Effect of cone reconstruction on right ventricular geometry and function in patients with Ebstein anomaly Xiao Li, Si-Meng Wang, Christian Schreiber, Wei Cheng, Ke Lin, Jia-Yu Sun, Dan Yang, Shu-Hua Luo, Qi An, Yu-Cheng Chen International Journal of Cardiology Volume 206, Pages 131-137 (March 2016) DOI: 10.1016/j.ijcard.2016.01.032 Copyright © 2016 Elsevier Ireland Ltd Terms and Conditions

Fig. 1 Cardiac magnetic resonance (CMR) imaging of Ebstein anomaly. A. CMR measurement of functional right ventricle end-diastolic volume (yellow) after cone reconstruction. Volume within the “cone” (surrounded by dash line; asterisk) was included in the calculation of right ventricular volume. B. Schematic diagram of the desynchronous tricuspid-valve movement associated with Ebstein anomaly. The yellow triangle represents the functional tricuspid annulus in the end-diastolic frame, while the red triangle represents it in the end-systolic frame. White arrows show the movement of the hinge points of the three leaflets. C. Measurement of ΔTL1-RVA and ΔTL2-RVA in the four-chamber view. D. Measurement of ΔTL3-RVA in the right-ventricle two-chamber view. In C and D, red lines (end-diastolic) and blue lines (end-systolic) are the segmental lines joining the right ventricular apex and each hinge point. ΔTL-RVA is the length of the red line minus the length of the corresponding blue line. AL, anterior leaflet; SL, septal leaflet; PL, posterior leaflet; RVA, right ventricular apex. (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.) International Journal of Cardiology 2016 206, 131-137DOI: (10.1016/j.ijcard.2016.01.032) Copyright © 2016 Elsevier Ireland Ltd Terms and Conditions

Fig. 2 CMR volume-rendered 3D images and parameters measured before cone reconstruction and at last follow-up. A. Ventricular shape before surgery. B. Ventricular shape in the same patient at last follow-up. C. RV EDV. D. RV EDV index. E. RV ESV index. F. RV EF. Round points indicate subjects. Triangles represent the median and interquartile range. RV, right ventricle; aRV, atrialized right ventricle; fRV, functional right ventricle; LV, left ventricle; EDV, end-diastolic volume; EF, ejection fraction; TAMSI, tricuspid annular movement synchronicity index. International Journal of Cardiology 2016 206, 131-137DOI: (10.1016/j.ijcard.2016.01.032) Copyright © 2016 Elsevier Ireland Ltd Terms and Conditions

Fig. 3 Tricuspid annular movement before cone reconstruction (A, B) and at follow-up (C, D), plus a healthy individual for comparison (E, F). A, C, E: transverse view. B, D, F: right ventricle two-chamber view. Red lines mark the tricuspid annular plane in the end-diastolic frame, while blue lines mark it in the end-systolic frame; arrows indicate the offset. E. TAMSI in Ebstein anomaly before and after surgery, and in normal control group. Blue boxes represent the 95% confidence interval, and whiskers, the range. AL, anterior leaflet; SL, septal leaflet; PL, posterior leaflet; TAMSI, tricuspid annular movement synchronicity index. (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.) International Journal of Cardiology 2016 206, 131-137DOI: (10.1016/j.ijcard.2016.01.032) Copyright © 2016 Elsevier Ireland Ltd Terms and Conditions