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Presence of reduced regional left ventricular function even in the absence of left ventricular wall scar tissue in the long term after repair of an anomalous left coronary artery from the pulmonary artery

Published online by Cambridge University Press:  01 November 2017

Sarah Nordmeyer ,
Boris Schmitt ,
Boris Nasseri ,
Vladimir Alexi-Meskishvili ,
Titus Kuehne ,
Felix Berger  and
Johannes Nordmeyer
Sarah Nordmeyer*
Affiliation:
Department of Congenital Heart Disease and Paediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany
Boris Schmitt
Affiliation:
Department of Congenital Heart Disease and Paediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany
Boris Nasseri
Affiliation:
Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Berlin, Germany
Vladimir Alexi-Meskishvili
Affiliation:
Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Berlin, Germany
Titus Kuehne
Affiliation:
Department of Congenital Heart Disease and Paediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany Institute for Computational and Imaging Sciences in Cardiovascular Medicine, Charité – Universitätsmedizin Berlin, Berlin, Germany
Felix Berger
Affiliation:
Department of Congenital Heart Disease and Paediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany
Johannes Nordmeyer
Affiliation:
Department of Congenital Heart Disease and Paediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany
*
Correspondence to: Dr S. Nordmeyer, MD, Department of Congenital Heart Disease and Paediatric Cardiology, Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353 Berlin, Germany. Tel: +49 304 593 2800; Fax: +49 304 593 2900; E-mail: snordmeyer@dhzb.de
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Abstract

Background

We sought to assess left ventricular regional function in patients with and without left ventricular wall scar tissue in the long term after repair of an anomalous origin of the left coronary artery from the pulmonary artery.

Methods

A total of 20 patients aged 12.8±7.4 years were assessed 10 (0.5–17) years after the repair of an anomalous origin of the left coronary artery from the pulmonary artery; of them, 10 (50%) patients showed left ventricular wall scar tissue on current cardiac MRI. Left ventricular regional function was assessed by two-dimensional speckle-tracking echocardiography in 10 patients with scar tissue and 10 patients without scar tissue and in 10 age-matched controls.

Results

In patients with scar tissue, MRI-derived left ventricular ejection fraction was significantly reduced compared with that in patients without scar tissue (51 versus 61%, p<0.05), and echocardiography-derived longitudinal strain was significantly reduced in five of six left ventricular areas compared with that in healthy controls (average relative reduction, 46%; p<0.05). In patients without scar tissue, longitudinal strain was significantly reduced in two of six left ventricular areas (average relative reduction, 23%; p<0.05) and circumferential strain was reduced in one of six left ventricular areas (relative reduction, 56%; p<0.05) compared with that in healthy controls.

Conclusions

Regional left ventricular function is reduced even in patients without left ventricular wall scar tissue late after successful repair of an anomalous origin of the left coronary artery from the pulmonary artery. This highlights the need for meticulous lifelong follow-up in all patients with a repaired anomalous origin of the left coronary artery from the pulmonary artery.

Keywords

Regional wall motionscar tissueanomalous origin of the left coronary artery from the pulmonary artery
Type
Original Articles
Information
Cardiology in the Young , Volume 28 , Issue 2 , February 2018 , pp. 200 - 207
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Copyright
© Cambridge University Press 2017 

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Footnotes

*

Felix Berger and Johannes Nordmeyer are contributed equally.

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