XXXX in @entity4263 and a Left Ventricle to Pulmonary Artery Conduit.

@entity1 @entity997 @entity4263 @entity409
BACKGROUND: The configuration of the interventricular septum can affect the function of the tricuspid valve in @entity1 with @entity4263 who have a systemically functioning right ventricle. Altering septal configuration by addressing a dysfunctional conduit placed between the left ventricle (LV) and the pulmonary artery (PA) in these @entity1 can impact septal configuration and competency of the tricuspid valve. METHODS: In 38 @entity1 with an LV to PA conduit, we evaluated relationships between conduit function, RV geometry, and tricuspid valve function, and compared these variables before and after conduit intervention. RESULTS: Median age at conduit implant was 4.5 years (0.5 to 36) and median total follow-up was 12 years (2 to 22). Of the 38 @entity1 , 23 (60%) underwent conduit intervention, a median of 7.5 years after implant. In 15 of these @entity1 (65%) the degree of @entity997 ( @entity997 ) worsened, compared with only 2 @entity1 (15%) in the non-intervention group (p < 0.001). Worsening @entity997 was associated with the degree of change in RV and LV ventricular diameters, change in tricuspid annulus size and tethering distance, and the degree of septal shift, as reflected by the right ventricular sphericity index (all p  <= 0.04). In 8 of 15 @entity1 with more severe @entity997 at follow-up, there was also progressive @entity409 . CONCLUSIONS: Intervention for LV to PA conduit dysfunction may result in worsening @entity997 and right ventricular function, likely due in part to altered septal shift due to changes in the interventricular pressure ratio. Management of LV to PA conduit dysfunction should take these findings into account.
