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.
Chauvaud
Sylvain M
SM
Department of Cardiovascular Surgery, Georges Pompidou European Hospital, Paris, France. sylvain.chauvaud@egp.ap-hop-paris.fr
Hernigou
Anne C
AC
Mousseaux
Elie R
ER
Sidi
Daniel
D
Hébert
Jean-Louis
JL
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