Right ventricular structure and function after novel repair of common arterial trunk

Abstract

Objectives: In an attempt to enhance applicability and outcomes of corrections of common arterial trunk, we have recently described a novel method of correction based on the concept of morphodynamism, and preserving the structure of the right ventricle. The intermediate influence of this operation on right ventricular (RV) structure and function have not been described. Methods and results: Thirty eight Patients (age: 1–12 months) underwent the novel repair. There were 2 early and 4 late deaths. All patients underwent early CT scans, 12 had repeat CT and 8 had MRI after 1 year or more from the operation. Detailed computerized analysis of the RV size, shape, pattern of contraction and function was performed. The shape and size were preserved, at the second investigation, with no evidence of dilatation of the neo-RV outflow, which appeared to contribute to overall function of the RV. The directional pattern of contraction showed enhanced longitudinal and radial contributions with minimal twisting. The movement of the RV free wall and septum were almost equal, with normal shape of the septum. The instantaneous pattern of contraction followed a consistent peristalsis sequence with significant contraction of both the body and the neo-outflow. The pulmonary regurgitant fraction, at follow up, varied from 22% to 42% (30 ± 6%) with preserved RV to pulmonary artery ventriculo-arterial coupling. Conclusion: The size, shape and pattern of contraction of the RV following the novel common arterial trunk repair appears to be well preserved in the intermediate term.

Keywords

• Aswan truncus operation (ATO)
• Morphodynamism
• Solid-fluid interaction
• RV pattern Of contraction
• CMR 4D flow