Ventricular volumes in Ebstein's anomaly: x-ray multislice computed tomography before and after repair.
BACKGROUND
This study was performed to measure right and left ventricular volumes in Ebstein's anomaly before and after operation.


METHODS
Twenty-six consecutive patients were operated on with tricuspid valve repair and plication of the atrialized right ventricle, associated with a bidirectional cavopulmonary shunt in 15 patients. Right ventricular (RV) and left ventricular end-diastolic and end-systolic volume indexes were measured by x-ray computerized tomography before and after surgical repair. Left ventricular stroke index and ejection fraction were calculated.


RESULTS
Before surgery, the mean stroke index of the atrialized RV was 36 +/- 33 mL/m2, with severe reduction in 9 patients and aneurysmal aspect in 2 patients. After surgery, the atrialized RV was no longer identifiable. Both RV end-diastolic volume index and stroke index of the remaining effective RV were reduced. Bidirectional cavopulmonary shunt was a determinant factor of decrease in the effective RV end-diastolic volume index after repair. Conversely, left ventricular ejection fraction and stroke index increased significantly after surgery.


CONCLUSIONS
The atrialized RV with dyskinesia seems a good indication for a plication. RV end-diastolic volume index of the effective RV decreased after surgery. In severe cases, bidirectional cavopulmonary shunt was useful by decreasing RV end-diastolic volume, thus preventing further RV dilation. In all cases left ventricular ejection fraction and stroke volume index increased after surgery.
Department of Cardiovascular Surgery, Georges Pompidou European Hospital, Paris, France. sylvain.chauvaud@egp.ap-hop-paris.fr
Sylvain M
SM
Chauvaud
Anne C
AC
Hernigou
Elie R
ER
Mousseaux
Daniel
D
Sidi
Jean-Louis
JL
Hébert
D000328:Adult; D004437:Ebstein Anomaly / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D005260:Female; D006352:Heart Ventricles / Q000473:pathology*; D006801:Humans; D008297:Male; D009929:Organ Size; D011182:Postoperative Care; D011300:Preoperative Care; D014057:Tomography, X-Ray Computed / Q000379:methods