Standard echocardiography:
All patients underwent complete transthoracic echocardiographic
examination according to the American Society of Echocardiography (ASE)
guidelines (15) using an ultrasound system; the General Electric (GE)
VIVID 9 ultrasound (Horten, Norway) equipped with a multi-frequency
transducer probe (3-8 MHz). The echocardiographic examination was done
at rest and children who were unable to completely rest during imaging
were given light sedation. Measurements were taken in three cardiac
cycles and average values were estimated offline and were used for
statistical analyses. Intra- and inter-observer variability was studied
based on two consecutive results.
Usual examination for Senning patients was done taking into
consideration the systemic tricuspid valve regurgitation, the pulmonary
and systemic venous baffles dysfunction (Leak or stenosis), the outflow
tracts (the left ventricular outflow tract obstruction (LVOT), and the
pulmonary valve dysfunction).
Common echocardiographic variables for RV function; RV end-diastolic
volume (RV EDV), RV end-systolic volume (RV ESV), and RV ejection
fraction (RV EF) were estimated in the apical four-chamber view, using
the automated Simpson’s one-plane method. RV EF was assessed
automatically by dividing RV EDV - RV ESV / RV EDV. (16) Right
ventricular tricuspid annulus plane systolic excursion (TAPSE) was
estimated as the amplitude of excursion of the tricuspid annulus from
the base toward the apex in systole using M-mode in the apical
four-chamber view with cursor was sited at the lateral aspect of the
tricuspid valve.