Right ventricular morphology and function following stage I palliation with a modified Blalock–Taussig shunt versus a right ventricle-to-pulmonary artery conduit
Key result
Stage I palliation with an RVPA conduit was associated with increased right ventricular dilatation (P=0.001) and reduced systolic longitudinal strain rate (P<0.0001) compared to an MBT shunt.
Why the study?
Does a right ventricle-to-pulmonary artery (RVPA) conduit compared to a modified Blalock-Taussig (MBT) shunt affect right ventricular morphology and function in patients with hypoplastic left heart syndrome?
Population
93 subjects with hypoplastic left heart syndrome undergoing stage I palliation, from two congenital centres.
Comparison
Right ventricle-to-pulmonary artery conduit vs Modified Blalock-Taussig (MBT) shunt (n=59)
Design
Cohort
Authors
Discussion
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Member takes
Implication
RVPA alters RV geometry in HLHS; leaves open long-term functional impact and optimal shunt selection.
Study Design
Type
Observational (n=93)
Multicenter
Yes
Structured PICO
Does a right ventricle-to-pulmonary artery (RVPA) conduit compared to a modified Blalock-Taussig (MBT) shunt affect right ventricular morphology and function in patients with hypoplastic left heart syndrome?
P
Population
93 subjects with hypoplastic left heart syndrome evaluated with cardiac magnetic resonance imaging following stage I palliation with either an MBT shunt or RVPA conduit.
E
Exposure
Right ventricle-to-pulmonary artery (RVPA) conduit (n=34)
C
Comparator
Modified Blalock-Taussig (MBT) shunt (n=59)
O
Outcome
Ventricular shape (dilatation and sphericity) and function (indices of strain including longitudinal and circumferential strain) assessed via cardiac magnetic resonance (CMR)surrogate
Main Result
p-value: p=<0.0001
In patients with hypoplastic left heart syndrome, stage I palliation with an RVPA conduit is associated with adverse right ventricular remodeling and reduced functional strain compared to an MBT shunt.
Cite This Study
Wong et al. (2016) conducted an observational in Hypoplastic left heart syndrome (HLHS) (n=93). Right ventricle-to-pulmonary artery (RVPA) conduit vs. Modified Blalock-Taussig (MBT) shunt was evaluated on Ventricular shape and functional strain (p=<0.0001). Stage I palliation with an RVPA conduit was associated with increased right ventricular dilatation (P=0.001) and reduced systolic longitudinal strain rate (P<0.0001) compared to an MBT shunt.