Spectrum of pulmonary valve morphology and its relationship to pulmonary trunk in tetralogy of Fallot
Background: Tetralogy of Fallot (TOF) is a complex congenital heart disease with anatomic variations. Although the pulmonary valve in TOF is abnormal, it has not been studied well, especially on newer imaging modalities such as multidetector computed tomography (CT), which gives excellent anatomic d...
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doaj-9e3b81a97c9c4a09af02f304c081da8c2021-07-28T00:14:12ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Radiology and Imaging0971-30261998-38082017-01-012701656910.4103/0971-3026.202959Spectrum of pulmonary valve morphology and its relationship to pulmonary trunk in tetralogy of FallotBinita R Chacko0George K Chiramel1Leena R Vimala2Devi A Manuel3Elizabeth Joseph4K Reka5Department of Radiology, Christian Medical College, Vellore, Tamil Nadu, IndiaDepartment of Radiology, Christian Medical College, Vellore, Tamil Nadu, IndiaDepartment of Radiology, Christian Medical College, Vellore, Tamil Nadu, IndiaDepartment of Cardiology, Christian Medical College, Vellore, Tamil Nadu, IndiaDepartment of Radiology, Christian Medical College, Vellore, Tamil Nadu, IndiaDepartment of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, IndiaBackground: Tetralogy of Fallot (TOF) is a complex congenital heart disease with anatomic variations. Although the pulmonary valve in TOF is abnormal, it has not been studied well, especially on newer imaging modalities such as multidetector computed tomography (CT), which gives excellent anatomic detail. Aims: The aim of this study was to assess the morphology of pulmonary valve in TOF on CT and evaluate its association with the degree of hypoplasia of infundibulum and pulmonary trunk. Materials and Methods: The cardiac CT scans of 30 patients with TOF were reviewed to evaluate the morphology of the pulmonary valve, infundibulum, and pulmonary arteries. Fisher's exact test was performed to examine the association between pulmonary valve morphology and degree of hypoplasia of the infundibulum and pulmonary trunk. Results: 16.7% of patients with TOF had pulmonary atresia. The prevalence of tricuspid, bicuspid, and absent valves were 10%, 53.3% and 6.7%, respectively. In another 13.3% of patients, although valve tissue was present, exact morphology could not be determined on CT. The commissures of 62.5% of the bicuspid valves were at 12 o'clock and 6 o'clock or slightly off the midline. There was statistically significant association between valve morphology and degree of infundibular hypoplasia (P < 0.001) and calibre of pulmonary trunk (P < 0.001). Conclusion: Morphological abnormality of the pulmonary valve is common in TOF. The most common type of pulmonary valve in TOF patients is bicuspid valve with commissures at 12 o'clock and 6 o'clock or slightly off the midline. Fewer cusps of the pulmonary valve are associated with a more severe degree of pulmonary artery hypoplasia.http://www.thieme-connect.de/DOI/DOI?10.4103/0971-3026.202959arteryhypoplasiapulmonarytetralogy of fallotvalve |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Binita R Chacko George K Chiramel Leena R Vimala Devi A Manuel Elizabeth Joseph K Reka |
spellingShingle |
Binita R Chacko George K Chiramel Leena R Vimala Devi A Manuel Elizabeth Joseph K Reka Spectrum of pulmonary valve morphology and its relationship to pulmonary trunk in tetralogy of Fallot Indian Journal of Radiology and Imaging artery hypoplasia pulmonary tetralogy of fallot valve |
author_facet |
Binita R Chacko George K Chiramel Leena R Vimala Devi A Manuel Elizabeth Joseph K Reka |
author_sort |
Binita R Chacko |
title |
Spectrum of pulmonary valve morphology and its relationship to pulmonary trunk in tetralogy of Fallot |
title_short |
Spectrum of pulmonary valve morphology and its relationship to pulmonary trunk in tetralogy of Fallot |
title_full |
Spectrum of pulmonary valve morphology and its relationship to pulmonary trunk in tetralogy of Fallot |
title_fullStr |
Spectrum of pulmonary valve morphology and its relationship to pulmonary trunk in tetralogy of Fallot |
title_full_unstemmed |
Spectrum of pulmonary valve morphology and its relationship to pulmonary trunk in tetralogy of Fallot |
title_sort |
spectrum of pulmonary valve morphology and its relationship to pulmonary trunk in tetralogy of fallot |
publisher |
Thieme Medical and Scientific Publishers Pvt. Ltd. |
series |
Indian Journal of Radiology and Imaging |
issn |
0971-3026 1998-3808 |
publishDate |
2017-01-01 |
description |
Background: Tetralogy of Fallot (TOF) is a complex congenital heart disease with anatomic variations. Although the pulmonary valve in TOF is abnormal, it has not been studied well, especially on newer imaging modalities such as multidetector computed tomography (CT), which gives excellent anatomic detail. Aims: The aim of this study was to assess the morphology of pulmonary valve in TOF on CT and evaluate its association with the degree of hypoplasia of infundibulum and pulmonary trunk. Materials and Methods: The cardiac CT scans of 30 patients with TOF were reviewed to evaluate the morphology of the pulmonary valve, infundibulum, and pulmonary arteries. Fisher's exact test was performed to examine the association between pulmonary valve morphology and degree of hypoplasia of the infundibulum and pulmonary trunk. Results: 16.7% of patients with TOF had pulmonary atresia. The prevalence of tricuspid, bicuspid, and absent valves were 10%, 53.3% and 6.7%, respectively. In another 13.3% of patients, although valve tissue was present, exact morphology could not be determined on CT. The commissures of 62.5% of the bicuspid valves were at 12 o'clock and 6 o'clock or slightly off the midline. There was statistically significant association between valve morphology and degree of infundibular hypoplasia (P < 0.001) and calibre of pulmonary trunk (P < 0.001). Conclusion: Morphological abnormality of the pulmonary valve is common in TOF. The most common type of pulmonary valve in TOF patients is bicuspid valve with commissures at 12 o'clock and 6 o'clock or slightly off the midline. Fewer cusps of the pulmonary valve are associated with a more severe degree of pulmonary artery hypoplasia. |
topic |
artery hypoplasia pulmonary tetralogy of fallot valve |
url |
http://www.thieme-connect.de/DOI/DOI?10.4103/0971-3026.202959 |
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