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Cardiac magnetic resonance in patients with pectus excavatum: impact of thoracic surgery on cardiac function - a follow- up-study
https://doi.org/10.1186/1532-429X-16-S1-P96
© Toepper et al.; licensee BioMed Central Ltd. 2014
- Published: 16 January 2014
Keywords
- Left Ventricle
- Stroke Volume
- Cardiac Magnetic Resonance
- Right Ventricle
- Pericardial Effusion
Background
Pectus excavatum (PE) as the most common anterior chest deformity is characterized by sternal depression with corresponding leftward displacement and rotation of the heart which is troublesome for assessment by ultrasound. Therefore CMR plays a growing role in preoperative evaluation. Indication for surgical correction is based on a diameter-based assessment of the thorax (Haller-Index, HI) and symptoms. Imaging data describing cardiac performance after surgery are rare. The aim of the study was to assess cardiac function during follow-up (FU).
Methods
Figure 1
Results
CMR images were evaluable despite implanted titanium bars. All patients completed one year FU. HI was significantly reduced after surgery (pre: 9.9 ± 5.7 vs. post: 2.8 ± 0.5, p < 0.001) indicating a successful procedure. Pleural effusions were detectable at day 10 in almost all (24 from 25 patients) pericardial effusion in 3 and it was resolved in all completely after 1 year. There were variable findings at different FU-time-points. The most positive change in RVEF was observed at 10 days FU followed by slight reduction on 3 months and further decrease at 1 year. Despite these findings the RVEF remained significantly improved at 1 year. Interestingly, RVEF was found to change significantly from baseline to 1 year FU (p < .0001), whereas LVEF did not (p = 0.0539). RVSV and LVSV were found to change significantly from baseline to 1 year follow-up (p = 0.0018 and 0.0008, respectively). Weak correlation was found between the delta (baseline/1 year) HI compared to RVEF.
Conclusions
CMR is able to quantify LV and RV-morphology despite specific anatomy and/or implanted titanium bows in patients with pectus excavatum. Our results indicate that there is an improvement of stroke volumes and RVEF one year post correction.
Funding
None.
Authors’ Affiliations
Copyright
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.