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The systemic right ventricle in congenitally corrected transposition of the great arteries is different from the right ventricle in dextro-transposition after atrial switch: a cardiac magnetic resonance study

Published online by Cambridge University Press:  14 June 2012

Matthias Grothoff ,
Antje Fleischer ,
Hashim Abdul-Khaliq ,
Janine Hoffmann ,
Lukas Lehmkuhl ,
Christian Luecke  and
Matthias Gutberlet
Matthias Grothoff*
Affiliation:
Department of Diagnostic and Interventional Radiology, University of Leipzig – Heart Center, Struempellstr. 39, 04289 Leipzig, Germany
Antje Fleischer
Affiliation:
Department of Diagnostic and Interventional Radiology, University of Leipzig – Heart Center, Struempellstr. 39, 04289 Leipzig, Germany
Hashim Abdul-Khaliq
Affiliation:
Department of Congenital Heart Disease/Pediatric Cardiology, University Saarland, Kirrberger Str. Gebäude 9, 66421 Homburg/Saar, Germany
Janine Hoffmann
Affiliation:
Department of Diagnostic and Interventional Radiology, University of Leipzig – Heart Center, Struempellstr. 39, 04289 Leipzig, Germany
Lukas Lehmkuhl
Affiliation:
Department of Diagnostic and Interventional Radiology, University of Leipzig – Heart Center, Struempellstr. 39, 04289 Leipzig, Germany
Christian Luecke
Affiliation:
Department of Diagnostic and Interventional Radiology, University of Leipzig – Heart Center, Struempellstr. 39, 04289 Leipzig, Germany
Matthias Gutberlet
Affiliation:
Department of Diagnostic and Interventional Radiology, University of Leipzig – Heart Center, Struempellstr. 39, 04289 Leipzig, Germany
*
Correspondence to: Dr M. Grothoff, MD, Department of Diagnostic and Interventional Radiology, University of Leipzig – Heart Center, Struempellstr. 39, 04289 Leipzig, Germany. Tel: +49 341 865 1702; Fax: +49 341 865 1803; E-mail: grothoff@gmx.de
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Abstract

Background

Patients with a congenitally corrected transposition of the great arteries show an increasing incidence of cardiac failure with age. In other systemic right ventricles, such as in dextro-transposition after atrial switch, excessive hypertrophy is a potential risk factor for impaired systolic function. In this trial, we sought to compare systemic function and volumes between patients with congenitally corrected transposition and those with dextro-transposition after atrial switch by using cardiac magnetic resonance imaging.

Methods and Results

A total of 19 patients (nine male) with congenitally corrected transposition and 31 patients (21 male) with dextro-transposition after atrial switch were studied using a 1.5-Tesla scanner. Cine steady-state free-precession sequences in standard orientations were acquired for volumetric and functional imaging. Patient parameters were compared with those of a group of 25 healthy volunteers. Although patients with congenitally corrected transposition were older, they presented with higher right ventricular ejection fractions (p = 0.04) compared with patients with dextro-transposition. Patients with congenitally corrected transposition showed a weak negative correlation between age at examination and systemic ejection fraction (r = −0.18, p = 0.04) but no correlation between right ventricular myocardial mass index and ejection fraction. There was no significant difference in the right ventricular end-diastolic volumes between both patient groups.

Conclusion

Although patients with congenitally corrected transposition had a longer pressure load of the systemic right ventricle, ventricular function was better compared with that in patients with dextro-transposition after atrial switch. The results suggest that the systemic ventricles might have partly different physiologies. One difference could be the post-operative situation after atrial switch, which results in impaired atrial contribution to ventricular filling.

Keywords

Congenitally corrected transposition of the great arteriescc-TGAsystemic right ventricleright ventricular failure
Type
Original Article
Information
Cardiology in the Young , Volume 23 , Issue 2 , April 2013 , pp. 239 - 247
Copyright
Copyright © Cambridge University Press 2012 

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