Long term follow-up of systemic right ventricle

Ciuca, Cristina (2021) Long term follow-up of systemic right ventricle, [Dissertation thesis], Alma Mater Studiorum Università di Bologna. Dottorato di ricerca in Scienze cardio nefro toraciche, 33 Ciclo.
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Abstract

Purpose: to assess the long-term follow-up in patients with systemic right ventricle. Methods: Seventy-three patients with systemic right ventricle (SRV) evaluated in the outpatient clinic between January 2014 and September 2020 were enrolled in this study. Thirty-four patients had a transposition of the great arteries treated either with Mustard or Senning procedure and 39 patients had a congenitally corrected transposition of the great arteries (ccTGA). Results: Mean age at the first evaluation was 29.6 ± 14.2 years, 47.9% were female. NYHA class at the visit was as follows: I in 53 % of cases, II in 33 % of cases, III 11% of cases and IV in 3% of cases. The first echocardiographic evaluation testifies end diastolic/systolic area 20.1 ± 5.3 cm2/m2 respectively 12.9 ± 4.4cm2/m2 significantly more dilated was the SRV of ASO patients. Overall, systolic function was normal or slightly impaired. A quarter of patients had significant tricuspid regurgitation (sTR). Cardiac MRI (CMR) confirmed the dilatation of the SRV end diastolic RV volume = 117 ± 40ml/m2 a RV ejection fraction = 49 ± 12%. Late gadolinium enhancement (LGE) was presented 42.3% of cases. CPET showed a reduced exercise capacity. Survival free from adverse events was 98.6% at one year and 95.8% at 5-year follow-up without difference between the two groups. The most common adverse event during follow-up the presence of arrhythmia requiring hospitalisation (27.1%) followed by signs of heart failure requiring hospitalisation (12.3%). The presence of LGE at CMR together with lower exercise capacity, higher NYHA class and more dilated and/or hypokinetic RV predicted a poorer outcome. Conclusions: Long term follow-up of patients with systemic right ventricle is characterized by a high incidence of clinical events, prevalently arrhythmias and heart failure which cause most of the unscheduled hospitalisations.

Abstract
Tipologia del documento
Tesi di dottorato
Autore
Ciuca, Cristina
Supervisore
Dottorato di ricerca
Ciclo
33
Coordinatore
Settore disciplinare
Settore concorsuale
Parole chiave
Systemic right ventricle, arrhythmias, heart failure, congenital heart disease, adults with congenital heart disease, atrial switch intervention, congenitally corrected transposition of the great arteries
URN:NBN
Data di discussione
26 Marzo 2021
URI

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