Phd ceremony H.G. Freling: Imaging of the right ventricle in congenital heart disease
|When:||Tu 21-01-2014 14:00 - 15:00|
In adulthood many patients with congenital heart disease develop complications of the right ventricle. Therefore, this ventricle is routinely assessed using MRI. This thesis investigated the influence of several methods to measure right ventricular volumes, as well as how to interpret right ventricular volumes and function in patients with different congenital heart diseases. Many patients have a conduction delay of the right ventricle. In these patients it is important to determine the end-systolic phase independently for the right and left ventricle. Papillary muscles and trabeculae, which are the muscles connected to the heart valves and small muscles on the inside of the heart, are often considered to be part of the blood volume because it is difficult to separate these muscles from blood when measuring right ventricular volumes. Measured blood volumes may significantly deviate from the true blood volume in patients with congenital heart disease. New semi-automatic software that can separate these muscles from blood helped us to show that the magnitude of this deviation is dependent on the underlying heart disease. Most patients with tetralogy of Fallot have an insufficient pulmonary valve. In addition to this insufficient valve, some patients also have a partly obstructed right ventricular outflow tract. Patients with this obstruction have smaller right ventricular volumes, but exercise capacity is lower. These improvements in right ventricular measurements are currently used in a multicenter study, ‘Functional outcome and quality of life in adult patients with congenital heart disease and prosthetic valves’.