The Annals of thoracic surgery · 2025
Exercise Performance and Right Ventricular Remodeling After the Cone Repair in Patients With Different Severity of Ebstein Anomaly.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Burri Melchior, Nagdyman Nicole, Hock Lina, Meierhofer Christian, Hock Julia, Cleuziou Julie, Lange Rüdiger
Аннотация
BACKGROUND: Although the cone repair has shown good outcome regarding valve competence, its effect on exercise performance and right ventricular remodeling are unclear.
METHODS: Between January 2010 and June 2021, 60 patients underwent a cone repair at our center. We excluded patients with previous operation (n = 6), age <5 years (n = 3), in-hospital death (n = 2), replacement before discharge (n = 1), and missing follow-up (n = 2), resulting in a study population of 46 patients. Median age was 27 years (interquartile range, 5.6-68.2 years), and 28 (61%) were female. Patients were divided based on indication: Group A, patients in New York Heart Association (NYHA) Functional Classification I or II without findings of severe/progressed disease; group B, patients in NYHA I or II and findings of severe/progressed disease on magnetic resonance imaging or spiroergometry; and group C, patients in NYHA III or IV.
RESULTS: Follow-up was 6.7 (SD, 3.7) years. Tricuspid regurgitation at the last follow-up was none-mild in 40 patients, moderate in 5, and severe in 1 patient, who underwent reoperation after 5.7 years. NYHA class improved in 18 patients, stayed equal in 24, and worsened in 4 (P = .002). Results of cardiopulmonary exercise testing showed no difference between preoperative and postoperative exercise capacity (preoperative: 72% of predicted vs postoperative: 71%, P = 1.0). Exercise-capacity improved only in group C. Indexed right ventricular-end-diastolic volume decreased from 166 mL/m2 to 114 mL/m2 (P < .001), and the reduction was smaller in group A (-13%) compared with groups B (-23%) and C (-53%). Antegrade stroke volume increased in every group (preoperative: 55 mL, postoperative: 72 mL; P = .005).
CONCLUSIONS: The cone repair results in a substantial and sustained decrease in tricuspid valve regurgitation. Although objective exercise capacity did not improve, NYHA class improved, right ventricle size decreased, and antegrade stroke volume increased.
METHODS: Between January 2010 and June 2021, 60 patients underwent a cone repair at our center. We excluded patients with previous operation (n = 6), age <5 years (n = 3), in-hospital death (n = 2), replacement before discharge (n = 1), and missing follow-up (n = 2), resulting in a study population of 46 patients. Median age was 27 years (interquartile range, 5.6-68.2 years), and 28 (61%) were female. Patients were divided based on indication: Group A, patients in New York Heart Association (NYHA) Functional Classification I or II without findings of severe/progressed disease; group B, patients in NYHA I or II and findings of severe/progressed disease on magnetic resonance imaging or spiroergometry; and group C, patients in NYHA III or IV.
RESULTS: Follow-up was 6.7 (SD, 3.7) years. Tricuspid regurgitation at the last follow-up was none-mild in 40 patients, moderate in 5, and severe in 1 patient, who underwent reoperation after 5.7 years. NYHA class improved in 18 patients, stayed equal in 24, and worsened in 4 (P = .002). Results of cardiopulmonary exercise testing showed no difference between preoperative and postoperative exercise capacity (preoperative: 72% of predicted vs postoperative: 71%, P = 1.0). Exercise-capacity improved only in group C. Indexed right ventricular-end-diastolic volume decreased from 166 mL/m2 to 114 mL/m2 (P < .001), and the reduction was smaller in group A (-13%) compared with groups B (-23%) and C (-53%). Antegrade stroke volume increased in every group (preoperative: 55 mL, postoperative: 72 mL; P = .005).
CONCLUSIONS: The cone repair results in a substantial and sustained decrease in tricuspid valve regurgitation. Although objective exercise capacity did not improve, NYHA class improved, right ventricle size decreased, and antegrade stroke volume increased.