Predictors of Early Right Ventricular Dysfunction after Cone Reconstruction for Ebstein’s Anomaly:A Retrospective Cohort Study  

作　　者：Jing Ling Naijimuding Abudurexiti Jiaxiong Wu Runzhang Liang Zirui Peng Yuting Huang Haiyun Yuan Shusheng Wen 

机构地区：[1]Department of Cardiovascular Surgery,Guangdong Cardiovascular Institute,Guangdong Provincial People’s Hospital,Guangdong Academy of Medical Sciences,Guangzhou,510080,China [2]National Clinical Research Center for Respiratory Disease,State Key Laboratory of Respiratory Disease,Guangzhou Institute of Respiratory Health,the First Afffliated Hospital,Guangzhou Medical University,Guangzhou,510080,China [3]Department of Cardiovascular Surgery,Guangdong Provincial People’s Hospital(Guangdong Academy of Medical Sciences),Southern Medical University,Guangzhou,510080,China [4]Guangdong Provincial Key Laboratory of South China Structural Heart Disease,Guangzhou,510080,China

出　　处：《Congenital Heart Disease》2025年第1期13-25,共13页先天性心脏病(英文)

基　　金：funded by E Fund Congenital Heart Disease Medical Talent Cultivation and Education Fund(grant number[2023QT0009]);the Science and Technology Planning Project of Guangdong Province(grant number[2023B03J1255]).

摘　　要：Background:Although Cone reconstruction has been shown to improve biventricular functionover time,postoperative right ventricular dysfunction(RVD)is frequently observed,signiffcantly affectingreoperation and long-term prognosis.This study aims to identify the predictors for postoperative RVD.Methods:This retrospective cohort study included 51 patients with Ebstein’s anomaly who underwentthe Cone reconstruction.RVD was deffned as right ventricular fractional area change(RV-FAC)lessthan 35%and tricuspid annular plane systolic excursion(TAPSE)less than 17 mm through pre-dischargeechocardiography.Univariate and multivariate analyses were used to analyze the pre-operative predictors.Results:The median age at surgery was 37.7(±15.3)years,RVD was documented in 25 patients(49%)of the51 patients.Patients with RVD had signiffcantly higher right ventricular end-systolic volume index(RVESVi)(p=0.001),right ventricular end-diastolic volume index(RVEDVi)(p=0.03),and septal leaffet displacement(p=0.003).Multivariate analysis conffrmed that septal leaffet displacement was independently associatedwith postoperative RVD(p=0.02).Additionally,RVD was not related to the cardiopulmonary bypass time,ICU stay and total hospital time.Conclusions:This study suggests that preoperative right ventricularejection fraction(RVEF)reduction,severe septal leaffet displacement and signiffcant right ventriculardilatation are key predictors of early postoperative RVD.RVD may exacerbate tricuspid regurgitation,andthis ffnding indicates that predicting RVD may aid in identifying high-risk patients prone to recurrence oftricuspid regurgitation after Cone reconstruction.

关 键 词：Cone reconstruction right ventricular dysfunction cardiac magnetic resonance 

分 类 号：R54[医药卫生—心血管疾病]