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3D modelling of atrial and ventricular shape and function in a patient following the new modified Mustard operation.

Aguib H, Chapron J, Donya M, Sedky Y, Hosny H, Yacoub M - Glob Cardiol Sci Pract (2015)

View Article: PubMed Central - PubMed

Affiliation: Aswan Heart Centre, Aswan, Egypt.

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There is a continuing need to perform inflow correction of “simple” TGA in a large subset of patients, who are not candidates for the arterial switch operation, particularly in developing countries... This is because of a lack of resources, centres and expertise to perform the neonatal switch operation... This subsequently results in the “late” presentation of patients who are severely cyanosed and have thin-walled, banana-shaped left ventricles which are not suitable for switching... There is growing evidence that the right ventricle can function normally into old age in certain patients with corrected TGA (AV and VA discordance)... Ourselves and others believe that the less-than-optimal results after the Mustard operation are, at least in part, due to an impaired pattern of left and right ventricular filling, produced by the relatively narrow, rigid, non-contractile channels in the atria, resulting in significant loss of the conduit, reservoir and contractile functions of the atria... The size and shape of the intra-atrial channels and of both ventricles during the different parts of the cardiac cycle play an important part in the Mustard operation... Further processing allowed isolation of the four heart chambers with boundaries defined at the valve levels... Those models were exported in 3-matic 9.0 (Materialise, Leuven, Belgium) to trim the inferior vena cava, superior vena cava and pulmonary veins... Importantly, pulsed Doppler interrogation of flow across the mitral valve showed a clear wave, indicating neo-atrial contribution to ventricular filling (Fig. 4)... These limitations need to be addressed in future studies... This investigation strongly suggests that the modified Mustard operation produces superior flow dynamics due to enhancement of conduit, reservoir and contractile functions of the neo atria, which should translate into enhanced survival and quality of life... Long-term results with a larger cohort of patients is required to validate these concepts.

No MeSH data available.


Unimpeded laminar flow at the left ventricular inflow at the level of the mitral valve.
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fig3: Unimpeded laminar flow at the left ventricular inflow at the level of the mitral valve.

Mentions: Colour flow mapping of the left ventricular inflow at the level of the mitral valve, showed unimpeded laminar flow (Fig. 3). Importantly, pulsed Doppler interrogation of flow across the mitral valve showed a clear wave, indicating neo-atrial contribution to ventricular filling (Fig. 4).


3D modelling of atrial and ventricular shape and function in a patient following the new modified Mustard operation.

Aguib H, Chapron J, Donya M, Sedky Y, Hosny H, Yacoub M - Glob Cardiol Sci Pract (2015)

Unimpeded laminar flow at the left ventricular inflow at the level of the mitral valve.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4374094&req=5

fig3: Unimpeded laminar flow at the left ventricular inflow at the level of the mitral valve.
Mentions: Colour flow mapping of the left ventricular inflow at the level of the mitral valve, showed unimpeded laminar flow (Fig. 3). Importantly, pulsed Doppler interrogation of flow across the mitral valve showed a clear wave, indicating neo-atrial contribution to ventricular filling (Fig. 4).

View Article: PubMed Central - PubMed

Affiliation: Aswan Heart Centre, Aswan, Egypt.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

There is a continuing need to perform inflow correction of “simple” TGA in a large subset of patients, who are not candidates for the arterial switch operation, particularly in developing countries... This is because of a lack of resources, centres and expertise to perform the neonatal switch operation... This subsequently results in the “late” presentation of patients who are severely cyanosed and have thin-walled, banana-shaped left ventricles which are not suitable for switching... There is growing evidence that the right ventricle can function normally into old age in certain patients with corrected TGA (AV and VA discordance)... Ourselves and others believe that the less-than-optimal results after the Mustard operation are, at least in part, due to an impaired pattern of left and right ventricular filling, produced by the relatively narrow, rigid, non-contractile channels in the atria, resulting in significant loss of the conduit, reservoir and contractile functions of the atria... The size and shape of the intra-atrial channels and of both ventricles during the different parts of the cardiac cycle play an important part in the Mustard operation... Further processing allowed isolation of the four heart chambers with boundaries defined at the valve levels... Those models were exported in 3-matic 9.0 (Materialise, Leuven, Belgium) to trim the inferior vena cava, superior vena cava and pulmonary veins... Importantly, pulsed Doppler interrogation of flow across the mitral valve showed a clear wave, indicating neo-atrial contribution to ventricular filling (Fig. 4)... These limitations need to be addressed in future studies... This investigation strongly suggests that the modified Mustard operation produces superior flow dynamics due to enhancement of conduit, reservoir and contractile functions of the neo atria, which should translate into enhanced survival and quality of life... Long-term results with a larger cohort of patients is required to validate these concepts.

No MeSH data available.