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Anatomic Correlates of Mitral Systolic Anterior Motion in Transposition of the Great Arteries Following Atrial Switch Operation

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Congenital Heart Disease 2023年第3期18卷 267-277页

作者： Norman Aiad Mark V.Sherrid Adam J.Small Youssef Elnabawi Jodi Feinberg Leon Axel Ralph Mosca T.K.Susheel Kumar michael argilla Dan G.Halpern Cardiovascular Division Leon H.Charney Division of CardiologyNYU Langone HealthSchool of MedicineNew York University GrossmanNew YorkUSA Department of Cardiovascular Disease Medical SchoolThe University of MinnesotaMinneapolisUSA The Lillehei Heart Institute MinneapolisMNUSA Radiology Department NYU Langone HealthSchool of MedicineNew York University GrossmanNew YorkUSA Cardiothoracic Surgery Department NYU Langone HealthSchool of MedicineNew York University GrossmanNew YorkUSA Pediatric Cardiology Division NYU Langone HealthSchool of MedicineNew York University GrossmanNew YorkUSA Department of Internal Medicine NYU Langone HealthSchool of MedicineNew York University GrossmanNew YorkUSA

Introduction:We sought to investigate whether the development of sub-pulmonic systolic anterior motion(SAM)may be inherent to the anatomy of the the mitral valve(MV)or affected by external factors,such as a dilated right ventricle or chest abnormalities in d-looped transposition of the great arteries post atrial switch operation(d-TGA/AtS).Methods:Analysis was performed of clinical and cardiac imaging studies acquired on 19 adult patients with d-TGA/AtS(age 42±6 years old,56%male)between 2015–*** data included mitral apparatus anatomy,and CT/MRI data included biventricular dimensions,function,and Haller index(HI)for pectus ***:Patients with leaflet SAM(n=6)compared to patients without SAM(n=13)had higher MV protrusion height(2.3±0.5 vs.1.5±0.4 cm,p≤0.01)and longer anterior MV leaflet length(3.1±0.4 cm vs.2.6±0.3 cm p≤0.05),when compared to those ***/MRI showed higher sub-pulmonic left ventricular ejection fraction(LVEF)in the SAM group(71%±8%vs.54%±7%,respectively).RV size and function,significant chest deformity(HI>3.5),presence of a ventricular lead pacemaker,and septal thickness did not play a role in development of ***:An elongated mitral apparatus is associated with the development of SAM,and the development of left ventricular outflow tract obstruction(LVOTO),in d-TGA/*** hyperkinesia is associated with *** RV dimensions,septal thickness,and degree of chest deformity did not differ significantly between subjects with SAM and those without.

关键词： d-loop transposition of the great arteries mustard operation senning operation systolic anterior motion of the mitral valve echocardiography cardiac MRI

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