Echocardiоgraphy assessment of right ventricle function in pre and post operative period after correction of pulmonary hypertension assoсiated pediatric congenital heart diseases

Abstract

Aim. Assessment of right ventricular function in preoperative and postoperative period by
using traditional transthoracic echocardiography in children with pulmonary hypertension
associated congenital heart defects.
Material and methods. From September 2022 to August 2023, echocardiographic measurements were performed at the AKFA Medline University Hospital on 25 patients with congenital heart defects (17 girls and 8 boys) aged from 6 months to 2 years. Tricuspid annulus plane systolic excursion (TAPSE) in M mode and systolic pulmonary artery pressure (SPAP) was
obtained as a main diagnostic echocardiography parameter. All TAPSE results were compared on 3 stage period: preoperative, early postoperative (1–2 days after surgical correction)
and late postoperative (1 month after discharge from hospital).
Results. Before the surgery in 12 children SPAP value ranged from 45–55 mm Hg and TAPSE
ranged from 12 – to 15 mm (mean 13,5 mm). In 13 children TAPSE ranged from 8–11 mm,
till – 2 by Z-score and SPAP was measured more than 55 mmHg. In the period of ICU in 17
children TAPSE consisted of 9-12 mm (more than -2,5 by Z-score) and SPAP decreased to
30 mmHg in early postoperative period after surgical correction of congenital heart defects. In 8 children TAPSE is showed 6-8 mm (more than -3,5 by Z-score) and SPAP 40 to 45
mmHg results. One months after discharging, TAPSE is gradually increased which TAPSE enhanced to 14–17 mm (0 or -1 by Z-score) in 20 children and in 5 patient TAPSE reached to
12–15 mm (till -2 by Z-score).
Conclusion. TAPSE is crucially dropped and well correlated with duration of ICU stay in
children after surgical correction of PH associated CHD and gradually increased in the late
post-operative period which indicates the risk of right ventricular failure in CHD with high
PH in early postoperative period.