Abstract
Abstract Background Pulmonary valve stenosis (PVS) is a common congenital heart disease that represents approximately 8%–10% of cardiac birth defects. Percutaneous pulmonary valvuloplasty is considered the procedure of choice whenever feasible. The impact of RV functions on outcomes in a broad range of conditions is well established, hence the importance of post-procedural long-term follow-up of RV volumes and functions. Aim and objectives To assess long-term RV functions and volumes by 3D echocardiography post-successful percutaneous pulmonary valvuloplasty and study the impact of age at intervention on 2D and 3D RV parameters. Methods We conducted a cross-sectional observational study on a cohort of 100 patients who had isolated congenital valvular pulmonary stenosis and had undergone successful balloon pulmonary valvuloplasty. The study included patients who had completed more than a year post-procedure and were present for routine follow-up echocardiography. Basic echocardiography was performed along with RV volumes and functions analysis using multi-beat full-volume 3D echocardiography. Result The study population consisted of 45 females (45.0%) and 55 males (55.0%) with ages ranging from 1.5–18 years and with a median (IQR) of [8.5 (4-10)]. 90 patients had normal RV functions by 2D RV S’, TAPSE, and FAC. By 3D analysis, RV EF was normal in 91 patients, indexed RV EDV was normal in 90 patients and high normal in 10 patients, indexed RV ESV was normal in 87 patients and high normal in 13 patients. When patients’ age at intervention was correlated to RV functions, age showed a significant negative correlation to 2D-derived as well as 3D-derived FAC and TAPSE with P values of 0.000, 0.011, 0.000, and 0.005 respectively. Moreover, age at intervention showed a positive statistically significant correlation to 3D-derived indexed RV EDV and indexed RV ESV with a P value of 0.000 and 0.000, and a significant negative correlation to 3D-derived RV EF with a P value of 0.000. Conclusion Percutaneous pulmonary valvuloplasty is an effective procedure in the long term, however, our preliminary data suggest that older age at intervention could have a negative impact on RV functions and volumes when assessed by 2D and 3D echocardiography. Further sub-analysis could be applied to confirm these findings and rule out any potential confounding factors.
Published Version
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