What question did this study set out to answer?

To evaluate the impact of right ventricular restoration via surgical ventriculoplasty during pulmonary valve implantation in adults with severe pulmonary regurgitation and right ventricular dilatation.

March 28, 2006European Journal of Cardio-Thoracic SurgeryOpen Access

Right ventricular restoration during pulmonary valve implantation in adults with congenital heart disease☆

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Why the study?

Does right ventricular restoration during pulmonary valve implantation improve right ventricular function in adults with severe pulmonary regurgitation and right ventricular dilatation?

Population

16 adult patients with severe pulmonary valve regurgitation and right ventricular dilatation with right…

Design

Case_series

Follow-up

16 months (6 months for MRI/IVC)

Authors

AFAlessandro FrigiolaCardiac Surgery AGAlessandro GiambertiVita-Salute San Raffaele University MCMassimo ChessaAdult Congenital Heart Disease

Discussion

Member takes

Implication

May support RV restoration during PVI in selected adults with severe PR; hypothesis-generating and requires controlled trials before practice change.

Key Points

To evaluate the impact of right ventricular restoration via surgical ventriculoplasty during pulmonary valve implantation in adults with severe pulmonary regurgitation and right ventricular dilatation.
Assessed 16 adult patients with severe pulmonary valve regurgitation, right ventricular dilatation, and outflow tract aneurysms operated on after January 2002.
Performed pulmonary valve implantation combined with aneurysm resection and volume-reducing ventriculoplasty sized to a 26 Hegar dilator, evaluating outcomes with Doppler echocardiography, MRI, and isovolumic contraction acceleration.
Followed patients over a 16-month period, including pre- and 6-month postoperative comparisons in 13 patients.
All 16 patients survived the operation and demonstrated clinical improvement alongside a reduced cardiothoracic index over 16 months of follow-up.
Right ventricular end-diastolic volume and end-systolic volume decreased significantly, while right ventricular ejection fraction increased.
Myocardial acceleration during isovolumic contraction increased from 0.7 ± 0.5 m/s² preoperatively to 1.3 ± 0.6 m/s² at 6 months post-surgery (n=13).

Structured PICO

Does right ventricular restoration during pulmonary valve implantation improve right ventricular function in adults with severe pulmonary regurgitation and right ventricular dilatation?

Population

16 adult patients with severe pulmonary valve regurgitation (PVR) and right ventricular dilatation with right ventricular outflow tract (RVOT) aneurysm, previously repaired for RVOT obstruction.

Intervention

Pulmonary valve implantation and RVOT restoration (removal of aneurysm tissue coupled with a ventriculoplasty to reduce volume, placing 2-0 Gortex suture to allow acceptance of a 26 Hegar dilator).

Outcome

Right ventricular recovery (reduction of RVEDV and RVESV, increased right ventricular ejection fraction, and right ventricular myocardial acceleration during isovolumic contraction [IVC]) and clinical improvement.surrogate

Right ventricular restoration during pulmonary valve implantation effectively improves right ventricular volumes and function in adults with severe pulmonary regurgitation and RVOT aneurysm.

Limitations

preliminary database

Cite This Study

Frigiola et al. (2006) studied this question.

synapsesocial.com/papers/6a70469fa2d7cf2e39c2a4f4 https://doi.org/10.1016/j.ejcts.2006.03.007

Topics

Congenital heart disease adults

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Implication

May support RV restoration during PVI in selected adults with severe PR; hypothesis-generating and requires controlled trials before practice change.

Right ventricular restoration during pulmonary valve implantation in adults with congenital heart disease☆

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Topics

Right ventricular restoration during pulmonary valve implantation in adults with congenital heart disease☆

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Also Consider

Topics

Also Consider