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Left ventricular rotation and torsion in neonates and infants younger than three months with symptomatic ventricular septal defect: Acute effects from open heart surgery
Author(s) -
Kwon Jung Eun,
Kim Yeo Hyang
Publication year - 2019
Publication title -
journal of clinical ultrasound
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.272
H-Index - 61
eISSN - 1097-0096
pISSN - 0091-2751
DOI - 10.1002/jcu.22650
Subject(s) - medicine , cardiology , diastole , basal (medicine) , fractional shortening , systole , velocity vector , ventricular function , torsion (gastropod) , surgery , blood pressure , insulin , engineering , aerospace engineering
Purpose We evaluated ventricular rotation, torsion, and strain changes in infants using preoperative and postoperative M‐mode echocardiography after early surgery for symptomatic ventricular septal defects (VSD). Methods Thirty‐five patients with VSD underwent vector velocity imaging echocardiography before and after open heart surgery. Their rotational variables were compared with 18 controls. Results All the patients (19 boys and 16 girls; median age: 44.4 days; range: 13‐84 days) showed normal septal motion preoperatively; however, septal motion changed into flat septum or paradoxical septal motion after surgery. Left ventricular end‐diastolic internal dimension and fractional shortening significantly decreased after surgery ( P = .001 and P = .000). Patients showed significant postoperative reduction of peak systolic apical rotation and maximal torsion ( P = .010 and P = .000). Peak systolic basal rotation decreased after surgery but it was not significantly ( P = .106). No significant differences were found in longitudinal and circumferential systolic strains between patients and controls. Conclusion Abnormal motion of the ventricular septum was confirmed by postoperative M‐mode echocardiography. Decreased rotation/torsion variables may reflect postoperative changes of ventricular loading conditions. Because systolic strain was preserved, postoperative echocardiographic results should not be interpreted as abnormal or decreased ventricular function.