Accuracy of Intraoperative Transesophageal Echocardiographic Doppler Parameters in Assessing the Right Ventricular Diastolic Function After Repair of Tetralogy of Fallot in Pediatric Patients.

IF 1.3 Q3 ANESTHESIOLOGY
Annals of Cardiac Anaesthesia Pub Date : 2025-01-01 Epub Date: 2025-01-24 DOI:10.4103/aca.aca_85_24
Nagarjuna Panidapu, Saravana Babu, Baiju S Dharan, Barsha Sen, Thomas Koshy
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Abstract

Background: This study aimed to assess the accuracy of tricuspid spectral Doppler (E/A) and tissue Doppler parameters (E/E') to diagnose right ventricular diastolic dysfunction (RVDD) in comparison to American Society of Echocardiography (ASE criteria) in pediatric tetralogy of Fallot (TOF) patients after surgical repair.

Methods: This prospective, observational study was done at a tertiary care hospital involving 40 pediatric TOF patients aged less than 2 years who underwent complete intracardiac repair with cardiopulmonary bypass (CPB). Echocardiographic observations were made using a pediatric transesophageal echocardiography probe after surgical repair in the post-CPB period. The ASE-described parameters (late diastolic forward flow in the main pulmonary artery, right atrial dilatation, inferior vena cava dilatation, and hepatic venous flow reversal) were acquired to diagnose the RVDD. The tricuspid Doppler parameters (E/A and E/E') were measured, and its predictive ability to diagnose RVDD was analyzed and compared with the ASE criteria.

Results: Based on the ASE criteria, 13 patients (32.5%) were diagnosed to have RVDD. We found that an E/E' ratio of ≥ 6.26 and an E/A ratio of >1.34 can be taken as the cutoff for diagnosing the RVDD. Based on the tricuspid Doppler parameters (E/A > 1.34 and E/E' >6.26), 17 patients (42.5%) were diagnosed to have RVDD, which was comparable to that of the diagnosis by ASE criteria (P > 0.05).

Conclusion: The results suggested that the use of tricuspid Doppler parameters can be equally accurate and reproducible to the current ASE-described echocardiographic parameters for diagnosing RVDD after surgical repair of TOF.

术中经食管超声心动图多普勒参数评价小儿法洛四联症修复后右心室舒张功能的准确性。
背景:本研究旨在评估三尖瓣频谱多普勒(E/A)和组织多普勒参数(E/E’)诊断右室舒张功能障碍(RVDD)的准确性,并与美国超声心动图学会(ASE)标准进行比较。方法:这项前瞻性观察性研究是在一家三级医院进行的,涉及40名年龄小于2岁的儿科TOF患者,他们接受了体外循环(CPB)的完全心内修复。超声心动图观察使用儿童经食管超声心动图探头后手术修复后的cpb期。根据ase描述的参数(舒张后期肺动脉前流、右心房扩张、下腔静脉扩张、肝静脉血流逆转)诊断RVDD。测定三尖瓣多普勒参数(E/A和E/E′),分析其诊断RVDD的预测能力,并与ASE标准进行比较。结果:根据ASE标准,13例(32.5%)患者被诊断为RVDD。我们发现E/E值≥6.26,E/A值≥1.34可作为诊断RVDD的截止值。基于三尖瓣多普勒参数(E/A > 1.34、E/E >6.26), 17例(42.5%)患者诊断为RVDD,与ASE诊断标准相当(P > .05)。结论:应用三尖瓣多普勒参数诊断TOF术后RVDD具有与现有ase描述超声心动图参数相同的准确性和可重复性。
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来源期刊
CiteScore
1.60
自引率
0.00%
发文量
147
审稿时长
26 weeks
期刊介绍: Annals of Cardiac Anaesthesia (ACA) is the official journal of the Indian Association of Cardiovascular Thoracic Anaesthesiologists. The journal is indexed with PubMed/MEDLINE, Excerpta Medica/EMBASE, IndMed and MedInd. The journal’s full text is online at www.annals.in. With the aim of faster and better dissemination of knowledge, we will be publishing articles ‘Ahead of Print’ immediately on acceptance. In addition, the journal would allow free access (Open Access) to its contents, which is likely to attract more readers and citations to articles published in ACA. Authors do not have to pay for submission, processing or publication of articles in ACA.
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