Abstract
Objective. To evaluate the changes in ventricular function using tissue Doppler and speckle tracking echocardiography in newborns with simple transposition of great arteries (TGA) before and after arterial switch and to identify parameters that determine the long stay in postoperative period.
Material and methods. Analyzed 30 newborns with simple TGA were treated in 2016–2017. The control group consisted of 12 somatically healthy children of the same age. Echocardiography was used to assess the anatomy of the defect, including detail morphometric parameters and the ventricular functional assessment by tissue Doppler and the speckle tracking echocardiography.
Results. The initial LV and RV systolic function in newborns with TGA did not differ from those in healthy newborns or were slightly reduced, but within the normal range. The global longitudinal deformation of the LV and RV and the maximum velocity of the motion mitral and tricuspid fibrous rings remained reduced in the postoperative period by the time of discharge. A negative correlation was found between the duration of cardiopulmonary bypass and the time of aortic clamp on the global longitudinal LV deformation in the postoperative period (ρ = –0.390, р = 0,044 and ρ = –0.390, р = 0,045, respectively). The following tendention was also revealed: the systolic movement tricuspid valve by tissue Doppler (S) in the postoperative period negatively correlated with the duration of mechanical ventilation (ρ = –0.374, p = 0.055).
Conclusions. 1. The maximum velocity of motion mitral and tricuspid fibrous rings and LV and RV global longitudinal deformation decrease in newborns with TGA after arterial switch and do not recover to normal values by the time of discharge. 2. Speckle tracking longitudinal deformation LV and RV in newborns with simple transposition of the great arteries did not show a prognostic significance in complicated postoperative period. 3. The duration of cardiopulmonary bypass affects LV and RV function, and the time of aortic cross-clamping mainly affects LV function. 4. Inclusion of new echocardiography techniques into the perioperative protocol ventricular function assessment will improve the quality of medical care for patients with TGA, reducing the length of stay in the hospital and, possibly, stratify the risks of delayed cardiac complications.
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About the authors
- Irina Yu. Baryshnikova, Cand. Med. Sci., Researcher, Ultrasonic Diagnostician; ORCID
- Rashid A. Sharipov, Cardiovascular Surgeon; ORCID
- Sergey V. Kalashnikov, Cand. Med. Sci., Researcher, Cardiovascular Surgeon; ORCID
- Inessa E. Nefedova, Dr. Med. Sci., Head of Neonatal Emergensy Surgery Department; ORCID
- David O. Berishvili, Dr. Med. Sci., Professor, Head of Department of Congenital Heart Disease; ORCID
- Leo A. Bockeria, Dr. Med. Sci., Professor, Academician RAS and RAMN, President; ORCID
