Borderline hypoplasia of the left ventricle in neonates: Insights for decision-making from functional assessment with magnetic resonance imaging Lars.

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Presentation transcript:

Borderline hypoplasia of the left ventricle in neonates: Insights for decision-making from functional assessment with magnetic resonance imaging Lars Grosse-Wortmann, MD, Tae-Jin Yun, MD, Osman Al-Radi, MD, Siho Kim, MD, Masaki Nii, MD, Kyong-Jin Lee, MD, Andrew Redington, MD, Shi-Joon Yoo, MD, Glen van Arsdell, MD The Journal of Thoracic and Cardiovascular Surgery Volume 136, Issue 6, Pages 1429-1436 (December 2008) DOI: 10.1016/j.jtcvs.2008.04.027 Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Short-axis slice at end-diastole in a patient with unbalanced atrioventricular septal defect. The left ventricle (LV) is compressed by the right (RV). The left atrioventricular valve is suspended by a single papillary muscle. The Journal of Thoracic and Cardiovascular Surgery 2008 136, 1429-1436DOI: (10.1016/j.jtcvs.2008.04.027) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Observed (A) and potential (B) left ventricular volumes: Assuming that the left ventricle is compressible but otherwise noncompliant, the endocardial circumference (C) in any short-axis plane should remain constant, irrespective of the filling state, whereas the encircled areas (A1 and A2) depend on the shape of the left ventricle. The potential volume can be calculated from the area and the thickness of the imaging slices. The Journal of Thoracic and Cardiovascular Surgery 2008 136, 1429-1436DOI: (10.1016/j.jtcvs.2008.04.027) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Left ventricular end-diastolic volume (LVEDV) measured by echocardiography versus magnetic resonance imaging (MRI), indexed to body surface area. A, Echocardiographic volume measurements, using the monoplane (mp) Simpson method from an apical 4-chamber view. B, Biplane (bp) echocardiographic volumetry from the apical 4-chamber and 2-chamber views. AS, Aortic stenosis; AVSD, atrioventricular septal defect; HLHC, hypoplastic left heart complex. The Journal of Thoracic and Cardiovascular Surgery 2008 136, 1429-1436DOI: (10.1016/j.jtcvs.2008.04.027) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Potential left ventricular end-diastolic volumes (LVEDV) by magnetic resonance imaging (MRI) compared with measured true preoperative volumes. Dotted black lines, Patients with critical aortic stenosis; broken gray lines, patients with unbalanced atrioventricular septal defect; solid black lines, patients with hypoplastic left heart complex. The Journal of Thoracic and Cardiovascular Surgery 2008 136, 1429-1436DOI: (10.1016/j.jtcvs.2008.04.027) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions

Figure 5 Postoperative growth after biventricular repair, monitored by serial echocardiograms: The first data point is the preoperative size; all subsequent points are postoperative measurements. Z-scores for (A) aortic valve annulus, (B) mitral valve annulus (excluding patients with atrioventricular septal defect), and (C) left ventricular end-diastolic diameter. The Journal of Thoracic and Cardiovascular Surgery 2008 136, 1429-1436DOI: (10.1016/j.jtcvs.2008.04.027) Copyright © 2008 The American Association for Thoracic Surgery Terms and Conditions