Computed Tomography-Based Ventricular Volumes and Morphometric Parameters for Deciding the Treatment Strategy in Children with a Hypoplastic Left Ventricle: Preliminary Results.
Objective
To determine the utility of computed tomography (CT) ventricular volumes and morphometric parameters for deciding the treatment strategy in children with a hypoplastic left ventricle (LV).


Materials and Methods
Ninety-four consecutive children were included in this study and divided into small LV single ventricle repair (SVR) (n = 28), small LV biventricular repair (BVR) (n = 6), disease-matched control (n = 19), and control (n = 41) groups. The CT-based indexed LV volumes, LV-to-right-ventricular (LV/RV) volume ratio, left-to-right atrioventricular valve (AVV) area ratio, left-to-right AVV diameter ratio, and LV/RV long dimension ratio were compared between groups. Proportions of preferred SVR in the small LV SVR group suggested by the parameters were evaluated.


Results
Indexed LV end-systolic (ES) and end-diastolic (ED) volumes in the small LV SVR group (6.3 ± 4.0 mL/m2 and 14.4 ± 10.2 mL/m2, respectively) were significantly smaller than those in the disease-matched control group (16.0 ± 4.7 mL/m2 and 37.7 ± 12.0 mL/m2, respectively; p < 0.001) and the control group (16.0 ± 5.5 mL/m2 and 46.3 ± 10.8 mL/m2, respectively; p < 0.001). These volumes were 8.3 ± 2.4 mL/m2 and 21.4 ± 5.3 mL/m2, respectively, in the small LV BVR group. ES and ED indexed LV volumes of < 7 mL/m2 and < 17 mL/m2, LV/RV volume ratios of < 0.22 and < 0.25, AVV area ratios of < 0.33 and < 0.24, and AVV diameter ratios of < 0.52 and < 0.46, respectively, enabled the differentiation of a subset of patients in the small LV SVR group from those in the two control groups. One patient in the small LV biventricular group died after BVR, indicating that this patient might not have been a good candidate based on the suggested cut-off values.


Conclusion
CT-based ventricular volumes and morphometric parameters can suggest cut-off values for SVR in children with a hypoplastic LV.
['Goo|Hyun Woo|HW|', 'Park|Sang-Hyub|SH|']
D016022:Case-Control Studies D054893:Cone-Beam Computed Tomography D005260:Female D006339:Heart Rate D006352:Heart Ventricles D006801:Humans D018636:Hypoplastic Left Heart Syndrome D007223:Infant D007231:Infant, Newborn D008297:Male D015203:Reproducibility of Results D012189:Retrospective Studies D013318:Stroke Volume D016276:Ventricular Function
Hypoplastic left ventricle Single ventricle repair Biventricular repair Cardiac CT Child Threshold-based segmentation Ventricular volume quantification