Pulmonary regurgitation follow up
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Pulmonic regurgitation Microchapters |
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Diagnosis |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Aysha Anwar, M.B.B.S[2], Aravind Kuchkuntla, M.B.B.S[3]
Overview
Follow up of patients with pulmonic regurgitation requires regular echocardiographic monitoring after PVR, oral anticoagulation in patients with mechanical or bioprosthetic valves and lifelong follow up to monitor pulmonary valve morphology and RV function.[1]
Follow Up
- All patients should undergo a baseline transthoracic echocardiogram after PVR.[1][2]
- Anticoagulation is recommended for patients with mechanical valves and aspirin for patients with bioprosthetic valves.[3]
- Oral anticoagulation among patients with bioprosthetic valves is recommended only when other indications such as atrial arrhythmia or prior thromoembolic event are present.
- All patients are advised for a lifelong follow up to assess the valvular morphology and RV systolic function.
- Rapid right ventricular (RV) dilatation has been reported to be associated with restrictive right ventricle (RV) physiology on initial MRI assessment. Therefore among patients with restrictive right ventricle (RV) physiology, optimal time for pulmonary valve implantation may be determined by careful follow-up.[4]
References
- ↑ 1.0 1.1 Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA; et al. (2008). "ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease). Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons". J Am Coll Cardiol. 52 (23): e143–263. doi:10.1016/j.jacc.2008.10.001. PMID 19038677.
- ↑ Baumgartner H, Bonhoeffer P, De Groot NM, de Haan F, Deanfield JE, Galie N; et al. (2010). "ESC Guidelines for the management of grown-up congenital heart disease (new version 2010)". Eur Heart J. 31 (23): 2915–57. doi:10.1093/eurheartj/ehq249. PMID 20801927.
- ↑ Jang W, Kim YJ, Choi K, Lim HG, Kim WH, Lee JR (2012). "Mid-term results of bioprosthetic pulmonary valve replacement in pulmonary regurgitation after tetralogy of Fallot repair". Eur J Cardiothorac Surg. 42 (1): e1–8. doi:10.1093/ejcts/ezs219. PMID 22561653.
- ↑ Shin, Yu Rim; Jung, Jo Won; Kim, Nam Kyun; Choi, Jae Young; Kim, Young Jin; Shin, Hong Ju; Park, Young-Hwan; Park, Han Ki (2016). "Factors associated with progression of right ventricular enlargement and dysfunction after repair of tetralogy of Fallot based on serial cardiac magnetic resonance imaging". European Journal of Cardio-Thoracic Surgery. 50 (3): 464–469. doi:10.1093/ejcts/ezw049. ISSN 1010-7940.