Pediatric Cardiology

Biography

Biography: Vanessa Canuto

Abstract

Introduction: Right ventricle evaluation is one of the major concerns in late postoperative of Tetralogy of Fallot (T4F). Pulmonary insufficiency results in ventricular dilation and consequently dysfunction. Time for re-intervention has been defined mainly by right ventricular end diastolic (RVEDV) and systolic (RVESV) volumes indexed by body surface in magnetic resonance imaging (MRI). Three-dimensional echocardiography (3DECHO) is a recent technology that calculates right ventricular volumes proposing to be an alternative diagnostic method for this population. Objective: This study sought to assess a possible correlation between RVEDV and RVESV acquired by 3DECHO and MRI from patients in late postoperative of T4F. Methods: Thirty patients were recruited for the study. Those with associated pathologies and moderate/severe residual lesions, except pulmonary insufficiency (PI), were excluded. 3DECHO was performed in our institution and MRI in referenced hospitals.
Results: Mean postoperative period was 24±10 years, mean age 26±12 years. Twenty-one (70%) patients had severe PI. Time average between 3DECHO and MRI studies was 1±1.5 years. There was good correlation of RVEDV (r=0.70, p<0.001) and RVESV (r=0.68, p<0.001) between methods, although there was slight discrepancy in larger volumes. After reaching high values, 3DECHO detected proportionally smaller volumes, underestimating the dilation when compared to MRI (gold standard). Nonetheless, RVEDV ≥99 ml/m² detected by 3DECHO had 69% of sensitivity and 93% of specificity in estimating RVEDV ≥140ml/m² detected by MRI. Conclusion: There was a significant correlation between 3DECHO and MRI right ventricular volumes. 3DECHO can be an alternative method to monitor right ventricle until the dilation reaches critical volumes. Nevertheless, to determine the ideal time of a surgical rapprochement, the MRI remains essential.