Abstract #3503

Wall Shear Stress and pulmonary regurgitation before and after TPVI for repaired tetralogy of Fallot: 4D flow MRI assessement.

HIROZUMI MORI¹, MICHINOBU NAGAO², Masahiro Jinzaki¹, and Hiroshi Hamano³

¹Department of Radiology, Keio University School of Medicine, Tokyo, Japan, ²Department of Diagnostic Imaging and Nuclear Medicine, Tokyo Womens Medical University, Tokyo, Japan, ³Philips Japan, Tokyo, Japan

Synopsis

Keywords: Vascular/Vessel Wall, Flow, adult congenital heart disease, 4d flow, pulmonary valve replacement, wall shear stress

Motivation: To evaluate Transcatheter Pulmonary Valve Implantation (TPVI) as an alternative to traditional open surgery for pulmonary regurgitation in repaired-Tetralogy of Fallot patients and to identify causes of regurgitation progression.

Goal(s):

Assess TPVI’s impact on cardiac function and pulmonary regurgitation.
Investigate wall shear stress (WSS) as a predictive factor.

Approach: In this prospective study of 20 patients, ventricular function, pulmonary regurgitation fraction, WSS, and pulmonary artery cross-sectional area were measured before TPVI, 3 months later, and for some (9 patients), 1 year later.

Results: TPVI reduced right ventricular volume and regurgitation fraction, and the preoperative early diastolic WSS was reduced, suggesting improved vascular remodeling.

Impact: 4D Flow MRI can assess early diastolic WSS derived from pulmonary regurgitation in repaired-Tetralogy of Fallot before TPVI, potentially serving as a new biomarker for predicting worsening of pulmonary regurgitation and considering TPVI indications.

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