Tricuspid Valve Adaptation during the First Interstage Period in Hypoplastic Left Heart Syndrome

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
Timothy ColenNee Scze Khoo

Abstract

Tricuspid regurgitation (TR) is an important risk factor for morbidity and mortality in hypoplastic left heart syndrome (HLHS), yet the evolution of tricuspid valve (TV) dysfunction in HLHS is poorly understood. This study sought to examine changes in TV function in HLHS between the first two stages of surgical palliation and to determine the mechanism of TR at the time of stage two surgery-bidirectional cavopulmonary anastomosis (BCPA). We prospectively investigated 44 infants at two time points-prior to Norwood-Sano (T1 - median age 5.4 days) and prior to BCPA (T2 - median age 4.7 months) using two-dimensional (2DE) and three-dimensional echocardiography (3DE). Right ventricular (RV) size, function and shape was assessed with 2DE. Extracted spatial coordinates from 3DE were used to calculate TV leaflet and annular area, tethering and prolapse volumes, bending angle, and coaptation index. TR was graded qualitatively, and 2D and 3D vena contracta (VC) were measured. The cohort from T1 to T2 had increased indexed leaflet and annular area (P < .0001) and tethering volume (P < .0001), with no change in coaptation. Significant TR was present in 14 infants (32%) at T2 and was associated with greater leaflet (P = .02) and annular are...Continue Reading

Citations

Jul 18, 2018·Circulation. Cardiovascular Imaging·Laura Mercer-Rosa, David J Goldberg
Dec 30, 2020·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Kandice MahTimothy Colen
Mar 24, 2021·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Ling LiShelby Kutty
Jun 21, 2021·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Sachie ShigemitsuTimothy Colen

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