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Regurgitant Fraction and branch pulmonary artery stenosis and Tetralogy of fallot

Rajesh Puranik, Victor Tsang, Philip Lurz, Vivek Muthurangu, Sophie Offen, Alessandra Frigiola, Wendy Norman, Fiona Walker, Philip Bonhoeffer, Andrew M Taylor
OBJECTIVE: Chronic pulmonary regurgitation (PR) has deleterious effects on right ventricular (RV) function in repaired tetralogy of Fallot (ToF). However, there are little data regarding right ventricular outflow tract (RVOT) contractile dysfunction in response to chronic PR and on both RV and LV volumes and function. METHODS: We retrospectively identified consecutive patients with PR who were referred for magnetic resonance imaging quantification of "free PR" detected on echocardiography between 2003 and 2008...
May 2012: Journal of Thoracic and Cardiovascular Surgery
Matthew A Harris, Kevin K Whitehead, Matthew J Gillespie, Timothy Y Liu, Michael T Cosulich, David C Shin, Elizabeth Goldmuntz, Paul M Weinberg, Mark A Fogel
OBJECTIVES: We sought to investigate whether differential branch pulmonary artery (BPA) regurgitation correlates with differences in BPA anatomy and physiology. BACKGROUND: Patients with repaired conotruncal anomalies such as Tetralogy of Fallot frequently have residual BPA stenosis or BPA size differences. Previous reports have demonstrated an increased left pulmonary artery (LPA) regurgitant fraction (RF) in these patients. METHODS: We retrospectively reviewed 76 consecutive cardiac magnetic resonance (CMR) studies for BPA size and phase-contrast magnetic resonance data, including 13 consecutive patients who underwent both CMR and catheterization...
May 2011: JACC. Cardiovascular Imaging
J Daniel Robb, Matthew A Harris, Masahito Minakawa, Evelio Rodriguez, Kevin J Koomalsingh, Takashi Shuto, David C Shin, Yoav Dori, Andrew C Glatz, Jonathan J Rome, Robert C Gorman, Joseph H Gorman, Matthew J Gillespie
BACKGROUND: Transannular patch (TAP) repair of tetralogy of Fallot often results in significant right ventricular outflow tract (RVOT) dilation and distortion. We hypothesized that insertion of Melody valves into the proximal right and left branch pulmonary arteries (PAs) would reduce pulmonary regurgitation fraction (PRF) in an ovine model of pulmonary insufficiency and dilated RVOT. METHODS AND RESULTS: Ten sheep underwent baseline cardiac catheterization, surgical pulmonary valvectomy, and TAP placement...
February 1, 2011: Circulation. Cardiovascular Interventions
R R Chaturvedi, P J Kilner, P A White, A Bishop, R Szwarc, A N Redington
BACKGROUND: Pulmonary regurgitation (PR) is an important determinant of outcome after repair of tetralogy of Fallot. Baseline PR was measured by magnetic resonance (MR) phase velocity mapping and from real-time right ventricular pressure-volume loops with a conductance catheter. Subsequently, the impact of two loading maneuvers (increased airway pressure, simulated branch pulmonary artery stenosis) on PR was assessed by the conductance catheter method. METHODS AND RESULTS: Thirteen patients, 3 to 35 years after tetralogy of Fallot repair or pulmonary valvotomy, had PR measured by MR phase velocity mapping while breathing spontaneously...
February 4, 1997: Circulation
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