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Course of Right Ventricular Function...
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Course of Right Ventricular Function in Patients with Pulmonary Insufficiency after Repair of Tetralogy of Fallot Marcus S. Schamberger, Roger A. Hurwitz. Indiana University, Indianapolis, Indiana Journal of the American College of Cardiology 1998, 31(2)Suppl:286A-287A and Pediatric Cardiology 2000,21(3):244-48 Background: Surgical repair of Tetralogy of Fallot (ToF) frequently results in pulmonary insufficiency (PI). Nevertheless, little information is available on the long term impact of PI on right ventricular function. Methods: 21 patients with at least moderate PI after repair of ToF were studied serially by radionuclide angiocardiography. The first (baseline) study was obtained a mean of 1.2 years (range 0.1 to 6.4) after surgery. The last study was performed a mean of 10.2 years (range 4.6 to 16.9) after surgery. Results: The mean RVEF at baseline was 0.52 ± 0.1 (normal: 0.53 ± 0.06; n.s.s). At the time of the last study the mean RVEF had decreased significantly to 0.45 ± 0.1 (p<0.01). At the last study 7 patients (33%) had a RVEF <0.42, which is >2 SD below our laboratory normal. Using 0.05 as our reproducibility factor for change in RVEF, 2 patients showed improvement in RVEF, 7 patients showed no change and 12 patients (57%) showed a decrease in RVEF. Conclusion: In spite of a normal early post operative RVEF, many patients with PI after repair of ToF show a significant decrease in RVEF during long term follow up. |
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