Novel echocardiographic score to predict duct-dependency after percutaneous relief of critical pulmonary valve stenosis/atresia.

Autor: Giordano M; Paediatric Cardiology Unit, University of Campania 'Luigi Vanvitelli', A.O.R.N. 'Ospedali dei Colli', Naples, Italy., Santoro G; Paediatric Cardiology Unit, University of Campania 'Luigi Vanvitelli', A.O.R.N. 'Ospedali dei Colli', Naples, Italy.; Paediatric Cardiology and GUCH Unit, Heart Hospital 'G. Pasquinucci', National Research Council-Tuscany Foundation 'G. Monasterio', Massa, Italy., Gaio G; Paediatric Cardiology Unit, University of Campania 'Luigi Vanvitelli', A.O.R.N. 'Ospedali dei Colli', Naples, Italy., Cappelli Bigazzi M; Paediatric Cardiology Unit, University of Campania 'Luigi Vanvitelli', A.O.R.N. 'Ospedali dei Colli', Naples, Italy.; Invasive Cardiology Unit, University of Campania 'Luigi Vanvitelli', A.O.R.N. 'Ospedali dei Colli', Naples, Italy., Esposito R; Paediatric Cardiology Unit, University of Campania 'Luigi Vanvitelli', A.O.R.N. 'Ospedali dei Colli', Naples, Italy., Marzullo R; Paediatric Cardiology Unit, University of Campania 'Luigi Vanvitelli', A.O.R.N. 'Ospedali dei Colli', Naples, Italy., Di Masi A; Paediatric Cardiology Unit, University of Campania 'Luigi Vanvitelli', A.O.R.N. 'Ospedali dei Colli', Naples, Italy., Palladino MT; Paediatric Cardiology Unit, University of Campania 'Luigi Vanvitelli', A.O.R.N. 'Ospedali dei Colli', Naples, Italy., Russo MG; Paediatric Cardiology Unit, University of Campania 'Luigi Vanvitelli', A.O.R.N. 'Ospedali dei Colli', Naples, Italy.
Jazyk: angličtina
Zdroj: Echocardiography (Mount Kisco, N.Y.) [Echocardiography] 2022 May; Vol. 39 (5), pp. 724-731. Date of Electronic Publication: 2022 Apr 24.
DOI: 10.1111/echo.15358
Abstrakt: Objectives: This study aimed to identify clinical, hemodynamic, or echocardiographic predictive features of persistent duct-dependency of pulmonary circulation (PDDPC) after effective percutaneous relief of pulmonary atresia with the intact ventricular septum (PA-IVS) or critical pulmonary stenosis (CPS).
Methods: From 2010 to 2021, 55 neonates with PA-IVS or CPS underwent percutaneous right ventricle (RV) decompression at our Institution. After successfully relief of critical obstruction, 27 patients (group I) showed PDDPC, whereas RV was able to support the pulmonary circulation in the remaining 28 patients (group II). Clinical, hemodynamic, and echocardiographic features of these two groups were compared.
Results: No significant difference in clinical and hemodynamic data was found between the groups, although the group I had a lower oxygen saturation at hospital admission. However, tricuspid valve (TV) diameter <8.8 mm, TV z-score ←2.12, tricuspid/mitral valve annular ratio <.78, pulmonary valve diameter <6.7 mm, pulmonary valve z-score ←1.17, end-diastolic RV area <1.35 cm 2 , end-systolic right atrium area >2.45 cm 2 , percentage amount of interatrial right-to-left shunt >69.5%, moderate/severe tricuspid regurgitation, RV systolic pressure >42.5 mmHg, tricuspid E/E' ratio >6.6 showed each significant predictive value of PDDPC. These parameters were used to build a composite echocardiographic score (PDDPC-score), assigning one point each above the respective cut-off value. A score ≥4.00 showed high sensitivity (100%) and specificity (86%) in predicting PDDPC.
Conclusion: Clinical and hemodynamic features fail to predict the short-term fate of the pulmonary circulation after successful treatment of PA-IVS/CPS. However, a simple, composite echocardiographic score is useful to predict PDDPC and could be crucial in the management of this frail subset of patients.
(© 2022 The Authors. Echocardiography published by Wiley Periodicals LLC.)
Databáze: MEDLINE
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