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Variations in right ventricular outflow tract morphology following repair of congenital heart disease: Implications for percutaneous pulmonary valve implantation

Schievano, S; Coats, L; Migliavacca, F; Norman, W; Frigiola, A; Deanfield, J; Bonhoeffer, P; (2007) Variations in right ventricular outflow tract morphology following repair of congenital heart disease: Implications for percutaneous pulmonary valve implantation. Journal of Cardiovascular Magnetic Resonance , 9 (4) 687 - 695. 10.1080/10976640601187596. Green open access

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Abstract

Objective: Our aim was to identify sub-groups of right ventricular outflow tract morphology that would be suitable for percutaneous pulmonary valve implantation and to document their prevalence in our patient population. Materials and Methods: Eighty-three consecutive patients with right ventricular outflow tract dysfunction (5-41 years, 76% tetralogy of Fallot) referred to our center for cardiovascular magnetic resonance were studied. A morphological classification was created according to visual assessment of three-dimensional reconstructions and detailed measurement. Diagnosis, right ventricular outflow tract type, surgical history and treatment outcomes were documented. Results: Right ventricular outflow tract morphology was heterogeneous; nevertheless, 5 patterns were visually identified. Type I, a pyramidal morphology, was most prevalent (49%) and related to the presence of a transannular patch. Other types (II-V) were seen more commonly in patients with conduits. Two patients had unclassifiable morphology. Ninety-five percent of patients were assigned to the correct morphological classification by visual assessment alone. Percutaneous pulmonary valve implantation was performed successfully in 10 patients with Type II-V morphology and in 1 patient with unclassifiable morphology. Percutaneous implantation was not performed in patients with Type I morphology. Only right ventricular outflow tract diameters < 22mmin diameter were suitable for the current device. Conclusions: We have created a morphological classification of the RVOT in patients referred for assessment of RVOT dysfunction. Though only 13% of our patients underwent percutaneous implantation, > 50% of outflow tract morphologies may be suitable for this approach, in particular with the development of new devices appropriate for larger outflow.

Type: Article
Title: Variations in right ventricular outflow tract morphology following repair of congenital heart disease: Implications for percutaneous pulmonary valve implantation
Identifier: PMID: 17578725
Open access status: An open access version is available from UCL Discovery
DOI: 10.1080/10976640601187596
Publisher version: http://dx.doi.org/110.1080/10976640601187596
Language: English
Additional information: Authors are the copyright holders of their articles and have granted to any third party, in advance and in perpetuity, the right to use, reproduce or disseminate the article.
Keywords: Right ventricular outflow tract, 3d reconstruction, transcatheter, pulmonary valve implantation, tetralogy, fallot, regurgitation, life
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Childrens Cardiovascular Disease
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Clinical Science
URI: https://discovery.ucl.ac.uk/id/eprint/137848
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