[I-P27-03] グレン手術後の左室及び僧帽弁のリモデリング
Keywords:グレン手術, 僧帽弁, 左室
【Background】 Theoretically bidirectional cavopulmonary anastomosis (BCPA) reduces ventricular volume load and improves effective pulmonary blood flow. However, there are limited studies of the changes in mitral valve (MV) and left ventricular (LV) morphology following BCPA.【Methods】The 2-D echocardiograms of 13 children (male, n=8; female, n=5) at the median age of 12 months (range, 7-28 months) with functional single ventricle anatomy and LV and MV of adequate size, 1 month before and after BCPA were performed between 2012 and 2018, were retrospectively reviewed. Patients who underwent MV repair at BCPA or had no appropriate images were excluded. From the 4-chamber view, the tenting area of MV and LV end-diastolic area before and after BCPA were measured and were indexed to the body surface area. LV sphericity index was also measured.【Results】After BCPA, LV end-diastolic area decreased from 3178±689 mm2/m2 to 2761±615 mm2/m2 (P＜0.05). The tenting area of the MV decreased from 127.2±59.2 mm2/m2 to 81.1±42.2 mm2/m2 (P＜0.05). The LV sphericity index tended to decrease after BCPA (0.59±0.14 vs 0.56±0.11, P=0.11), although it was not significantly different.【Conclusions】 In children with functional single LV, the coaptation of the MV improved concomitantly with LV end-diastolic area shortly after BCPA. It is suggested that there be LV and MV remodeling accompanying reduction in ventricular load following BCPA.