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Cardiovascular Magnetic Resonance predictors for pulmonary valve replacement in Tetralogy of Fallot patients
Session:
Posters (Sessão 5 - Écran 3) - Imagem multimodal 2
Speaker:
Catarina Costa
Congress:
CPC 2023
Topic:
B. Imaging
Theme:
03. Imaging
Subtheme:
03.6 Cross-Modality and Multi-Modality Imaging Topics
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Catarina Martins Da Costa; João Calvão; Ana Filipa Amador; Andre Cabrita; Catarina Amaral Marques; Joao Rebelo; André Carvalho; António José Madureira; Cristina Cruz; Teresa Pinho; Filipe Macedo
Abstract
<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong>Background:</strong> <span style="background-color:white"><span style="color:black">Criteria for pulmonary vale replacement (PVR) in Tetralogy of Fallot (ToF) patients are based on clinical data and </span></span>Cardiovascular magnetic resonance (CMR)<span style="background-color:white"><span style="color:black"> parameters mainly. However optimal timing remains challenging. </span></span>We studied our cohort of ToF patients to access CMR predictors for PVR.</span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong>Methods:</strong> We included adult patients (pts) with repaired ToF with active follow-up between 2000 and 2022 in a single tertiary care center. Last CMR previous to PVR or most recent CMR were considered as appropriate. </span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="background-color:white"><span style="font-family:"Times New Roman",serif"><strong><span style="color:black">Results:</span></strong><span style="color:black"> One hundred sixty-two pts were eligible (female 82 (51%)) with a median follow up of 35 (interquartile range – IQR - 17) years. Moderate to severe pulmonary regurgitation (PR) evolved in 122 (75%) pts; among these mean regurgitation fraction and regurgitation volume was 42 ± 13% and 52 ± 26 ml, respectively, and fourteen (11%) patients presented in NYHA class II-III. Right ventricle outflow tract aneurism was associated with moderate to severe PR (28% vs 10%; p=0.019), while late gadolinium enhancement was not (98% vs 95%; p=0.455). </span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="background-color:white"><span style="font-family:"Times New Roman",serif"><span style="color:black">Forty-seven (29%) pts were proposed to PVR. RVSV index/ RVEDV index ratio showed good correlation with indication to surgery among patients with moderate to severe PR (0.39 ± 0.1 vs 0.50 ± 021; p <0.001) and as well as LVEDV index /RVEDV index (0.54 ± 0.1 vs 0.62 ± 0.2; p =0.008). LVSV index/ RVSV index did not show any association (0.8 (0.4) vs 0.7 (0.2); p=0.198).</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:"Times New Roman",serif"><strong>Conclusion: </strong>CMR is<strong> </strong>an essential technique to access pulmonary valve, right ventricle morphology and function in TOF pts. Factors as right ventricle outflow tract aneurism, RVSV index/ RVEDV index ratio and LVEDV index /RVEDV index may be usefull to establish optimal timing for pulmonary valve intervention. Larger studies with prognostic data are important to confirm this hypothesis.</span></span></p>
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