Echocardiographic study for the children with transposition of the great arteries with intact ventricular septum after neonatal period / 中华超声影像学杂志

ABSTRACT

Objective To identify the suitable echocardiographic predictor,the standard 2-demensional echocardiography and speckle tracking imaging (STI) techniques were applied for the late referred children with transposition of great arteries with intact ventricular septum (TGA-IVS) after neonatal period.Methods 22 children with TGA-IVS after neonatal period were enrolled.According to the intraoperative left ventricular (LV)/right ventricular systolic pressure ratio,they received pulmonary artery banding (PAB group,n =10) or arterial switch operation (ASO group,n =12).15 body surface area matched healthy children were served as control group,Echocardiography was performed before the operation.The dynamic images in basal and apical short axis view were collected respectively.Meanwhile,using the STI technique,the rotation curves at apex and base was analyzed.Results All the patients discharged eventually.A right to left bulging of the ventricular septum was observed in all the patients by the 2D short-axis view.There were no differences in wall thickness and ejection fraction between control,PAB and ASO group.Compared with the control group,the end diastolic diameter,end diastolic volume and indexed LV mass in PAB and ASO group were significantly reduced,however,no difference in the end diastolic diameter and volume and LV mass was observed between the PAB and ASO group.The hypoplasia of LV in PAB and ASO group was associated with an extended time to peak basal rotation and reduced basal rotation and global torsion.Furthermore,the shorter time to peak apical rotation and reduced apical rotation and global torsion were only observed in PAB group.Conclusions The standard echocardiography could be useful for the initial evaluation for regressed LV of the children with TGA-IVS.However,STI allows a much more precious approach to the assessment of LV regressing after neonatal period.The apical rotation and global torsion might be the better predictor to identify the borderline or regressed LV for the surgical management for the children with TGA-IVS.