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dc.contributor.authorWong, Jamesen_US
dc.contributor.authorLamata, Pabloen_US
dc.contributor.authorRathod, Rahul H.en_US
dc.contributor.authorBertaud, Sophieen_US
dc.contributor.authorDedieu, Nathalieen_US
dc.contributor.authorBellsham-Revell, Hannahen_US
dc.contributor.authorPushparajah, Kuberanen_US
dc.contributor.authorRazavi, Rezaen_US
dc.contributor.authorHussain, Tariqueen_US
dc.contributor.authorSchaeffter, Tobiasen_US
dc.contributor.authorPowell, Andrew J.en_US
dc.contributor.authorGeva, Talen_US
dc.contributor.authorGreil, Gerald F.en_US
dc.date.accessioned2017-02-18T01:57:48Z
dc.date.issued2016en_US
dc.identifier.citationWong, J., P. Lamata, R. H. Rathod, S. Bertaud, N. Dedieu, H. Bellsham-Revell, K. Pushparajah, et al. 2016. “Right ventricular morphology and function following stage I palliation with a modified Blalock–Taussig shunt versus a right ventricle-to-pulmonary artery conduit.” European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery 51 (1): 50-57. doi:10.1093/ejcts/ezw227. http://dx.doi.org/10.1093/ejcts/ezw227.en
dc.identifier.issn1010-7940en
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:30370917
dc.description.abstractOBJECTIVES The Norwood procedure for hypoplastic left heart syndrome (HLHS) is performed either via a right ventricle-to-pulmonary artery (RVPA) conduit or a modified Blalock–Taussig (MBT) shunt. Cardiac magnetic resonance (CMR) data was used to assess the effects of the RVPA conduit on ventricular shape and function through a computational analysis of anatomy and assessment of indices of strain. METHODS A retrospective analysis of 93 CMR scans of subjects with HLHS was performed (59 with MBT shunt, 34 with RVPA conduit), incorporating data at varying stages of surgery from two congenital centres. Longitudinal and short-axis cine images were used to create a computational cardiac atlas and assess global strain. RESULTS Those receiving an RVPA conduit had significant differences (P< 0.0001) in the shape of the RV corresponding to increased ventricular dilatation (P = 0.001) and increased sphericity (P = 0.006). Differences were evident only following completion of stage II surgery. Despite preserved ejection fraction in both groups, functional strain in the RVPA conduit group compared with that in the MBT shunt group was reduced across multiple ventricular axes, including a reduced systolic longitudinal strain rate (P< 0.0001), reduced diastolic longitudinal strain rate (P = 0.0001) and reduced midventricular systolic circumferential strain (P < 0.0001). CONCLUSIONS Computational modelling analysis reveals differences in ventricular remodelling in patients with HLHS undergoing an RVPA conduit insertion with focal scarring and volume loading leading to decreased functional markers of strain. The need for continued surveillance is warranted, as deleterious effects may not become apparent until later years.en
dc.language.isoen_USen
dc.publisherOxford University Pressen
dc.relation.isversionofdoi:10.1093/ejcts/ezw227en
dc.relation.hasversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC5226069/pdf/en
dash.licenseLAAen_US
dc.subjectCongenitalen
dc.subjectHypoplastic left heart syndromeen
dc.subjectNorwood procedureen
dc.subjectCardiac MRIen
dc.titleRight ventricular morphology and function following stage I palliation with a modified Blalock–Taussig shunt versus a right ventricle-to-pulmonary artery conduiten
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden
dc.relation.journalEuropean Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgeryen
dash.depositing.authorRathod, Rahul H.en_US
dc.date.available2017-02-18T01:57:48Z
dc.identifier.doi10.1093/ejcts/ezw227*
dash.authorsorderedfalse
dash.contributor.affiliatedRathod, Rahul
dash.contributor.affiliatedGeva, Tal
dash.contributor.affiliatedPowell, Andrew


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