@Article{chd.2022.021509,
AUTHOR = {Benjamin Zielonka, David M. Harrild, Sunil J. Ghelani, Eleni G. Elia, Christopher W. Baird, Andrew J. Powell, Rahul H. Rathod},
TITLE = {A Ring-Reinforced Right Ventricle to Pulmonary Artery Conduit is Associated with Better Regional Mechanics after Stage I Norwood Operation},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {17},
YEAR = {2022},
NUMBER = {5},
PAGES = {591--603},
URL = {http://www.techscience.com/schd/v17n5/49564},
ISSN = {3071-1738},
ABSTRACT = {<b>Background: </b>The right ventricle to pulmonary artery conduit (RVPAC) may impair right ventricular (RV) function in patients with functional single right ventricles. Modification of the RVPAC using a ring-reinforced end
with dunked insertion into the RV through a limited ventriculotomy may reduce the impact on RV function.
We compared RV segmental strain between patients with a traditional RVPAC and ring-reinforced RVPAC using
feature tracking cardiovascular magnetic resonance (CMR) imaging. <b>Methods:</b> Patients with CMR examinations
after Stage I operation with RVPAC between 2000 and 2018 were reviewed. Ventricular mass, volumes, late gadolinium enhancement (LGE), and peak radial and circumferential strain of the 4 segments near the RVPAC insertion site were analyzed. <b>Results:</b> The study included 71 CMR examinations in 61 patients (30 traditional RVPAC,
31 ring-reinforced RVPAC). Prior to Stage II, the ring-reinforced RVPAC group had better peak radial strain and
circumferential strain in 1 of 4 segments proximal to the RVPAC insertion site compared to the traditional
RVPAC group. Prior to Stage III operation, the ring-reinforced group had better peak radial and circumferential
strain in 2 of 4 segments. LGE at the RVPAC insertion site was observed in 97% of patients before Stage II and
95% of patients before Stage III. RVPAC type and regional strain were not associated with transplant-free survival
during a median follow-up of 6.3 years. <b>Conclusions:</b> Compared to a traditional RVPAC, the ring-reinforced
RVPAC is associated with improved regional mechanics at the conduit insertion site. Further investigation of
long-term outcomes after ring-reinforced RVPAC is warranted.},
DOI = {10.32604/chd.2022.021509}
}