Left ventricular function in children with Coarctation of the Aorta

Session

Medicine and Nursing

Description

Surgical repair of coarctation of the aorta (CoA) is a safe procedure in children, however the condition is known for its potential recurrence and other related complications. The available evidence shows abnormal intrinsic properties of the aorta in CoA, thus suggesting additional effect, even after CoA repair, on left ventricular (LV) function. Accordingly, we sought to obtain a better understanding of LV myocardial mechanics in very early-corrected CoA using two-dimensional STE. Methods and results: We retrospectively studied 21 patients with corrected CoA at a median age of 9 (2–53) days at three time points: 1) just before intervention, 2) at short-term follow-up (within 3 months after intervention) and 3) at medium-term follow-up after intervention (median 2.3 years) and compared them with normal values. Speckle tracking analysis was conducted via vendor independent software, Tomtec. After intervention, LV function significantly improved (from −12.8 ± 3.9 to −16.7 ± 1.7; p < 0.001), however normal values were not reached even at medium-term follow-up (−18.3 ± 1.7 vs. −20 ± 1.6; p = 0.002). Medium-term longitudinal strain correlated with pre intervention EF (r = 0.58, p = 0.006). Moreover, medium-term subnormal values were more frequently associated with bicuspid aortic valve (33.3% vs. 66.6%; p < 0.05). Conclusion: LV myocardial function in neonates with CoA can be feasibly evaluated and followed up by speckle tracking echocardiography. LV subendocardial dysfunction however, remains in early infancy coarctation long after repair. Long-term follow-up through adulthood using myocardial deformation measurements should shed light on the natural history and consequences of this anomaly.

Session Chair

Besnik Elshani

Session Co-Chair

Valdete Serreqi

Proceedings Editor

Edmond Hajrizi

ISBN

978-9951-437-96-7

Location

Lipjan, Kosovo

Start Date

31-10-2020 10:45 AM

End Date

31-10-2020 12:15 PM

DOI

10.33107/ubt-ic.2020.413

This document is currently not available here.

Share

COinS
 
Oct 31st, 10:45 AM Oct 31st, 12:15 PM

Left ventricular function in children with Coarctation of the Aorta

Lipjan, Kosovo

Surgical repair of coarctation of the aorta (CoA) is a safe procedure in children, however the condition is known for its potential recurrence and other related complications. The available evidence shows abnormal intrinsic properties of the aorta in CoA, thus suggesting additional effect, even after CoA repair, on left ventricular (LV) function. Accordingly, we sought to obtain a better understanding of LV myocardial mechanics in very early-corrected CoA using two-dimensional STE. Methods and results: We retrospectively studied 21 patients with corrected CoA at a median age of 9 (2–53) days at three time points: 1) just before intervention, 2) at short-term follow-up (within 3 months after intervention) and 3) at medium-term follow-up after intervention (median 2.3 years) and compared them with normal values. Speckle tracking analysis was conducted via vendor independent software, Tomtec. After intervention, LV function significantly improved (from −12.8 ± 3.9 to −16.7 ± 1.7; p < 0.001), however normal values were not reached even at medium-term follow-up (−18.3 ± 1.7 vs. −20 ± 1.6; p = 0.002). Medium-term longitudinal strain correlated with pre intervention EF (r = 0.58, p = 0.006). Moreover, medium-term subnormal values were more frequently associated with bicuspid aortic valve (33.3% vs. 66.6%; p < 0.05). Conclusion: LV myocardial function in neonates with CoA can be feasibly evaluated and followed up by speckle tracking echocardiography. LV subendocardial dysfunction however, remains in early infancy coarctation long after repair. Long-term follow-up through adulthood using myocardial deformation measurements should shed light on the natural history and consequences of this anomaly.