Abstract
Pulmonary regurgitation (PR) is the most common complication after tetralogy of Fallot (TOF) surgical repair, and long-term PR might result in cardiovascular events. The aim of this study was to assess the influence of pre-operative right ventricle (RV) and pulmonary artery (PA) parameters assessed by dual-source computed tomography on post-operative PR. A total of 41 TOF patients who underwent trans-valve surgical repair were retrospectively recruited. The RV and PA parameters evaluated by pre-operative DSCT were compared between the PR and non-PR groups. Our result revealed that the PA parameters (McGoon ratio, Nakata index, and LPA diameter) and RV parameters (RV length diameter and RV short diameter) all showed significant differences between the two groups (all p < 0.05). There was a significant correlation between PR and LPA diameter (r = 0.361), McGoon ratio (r = 0.413), and Nakata index (r = 0.482). Receiver operating characteristic analysis also revealed a moderate sensitivity and specificity of LPA (66.33%; 82.60%), McGoon ratio (83.33%, 56.52%), and Nakata index (83.33%; 60.87%) for predicting the occurrence of PR. This study indicated that these pre-operative indices calculated by DSCT are associated with post-operative PR and that these pre-operative PA and RV parameters may serve as novel predictors of the risk of PR.
Highlights
Tetralogy of Fallot (TOF) is one of the most common cyanotic congenital heart diseases (CHDs), and pulmonary regurgitation (PR) is the most common complication after tetralogy of Fallot (TOF) surgical repair
A total of 55 patients who did not pre-operative Pulmonary regurgitation (PR) were enrolled in the study, these included 20 patients in whom post-operative PR was confirmed by Trans-thoracic echocardiography (TTE) and 35 patients who did not have postoperative PR
We demonstrated that PR is more likely to occur in patients who have undergone trans-valve surgery (90.0%)
Summary
Tetralogy of Fallot (TOF) is one of the most common cyanotic congenital heart diseases (CHDs), and pulmonary regurgitation (PR) is the most common complication after TOF surgical repair. Trans-thoracic echocardiography (TTE) as the traditional and routine clinical investigation for TOF, is good at hemodynamic detection; the results of TTE are largely dependent on the operators. Numerous TOF-related studies have focused on the clinical managements after the TOF surgical repair, such as the close monitoring of ventricle function changes in the long-term postoperative follow-up, discussion about indications, methods, and optimal timing of pulmonary valve replacement (PVR) have persisted[6,7,8,9,10]. Study has pointed out that trans-valve surgical repair has been linked with post-operative www.nature.com/scientificreports/. PR, the preoperative anatomic characteristics, which play a major role in deciding the surgical approach and the response of the perivalvular structures to the hemodynamic load have not been thoroughly discussed[11,12,13]
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