[Correction of tetralogy of Fallot and its influence to oxygen transport and lung changes. Part I. Oxygen transport (author's transl)].
30 patients with tetralogy of Fallot were examined before and after correction. 10 of whom had previous procedures including 13 Blalock-Taussig shunts, 1 Cooley anastomosis and 6 pulmonary valvulotomies (Brock) with a dilator. Hemoglobin and blood gases were measured in 22 patients pre- and postoperatively on the 7th respectively 14th day and finally after 12 months. In 8 children the concentration of 2,3-DPG was accessed (pre-, postoperatively, immediately in ICU, on the 1st, 7th, 14th day and after 21 months). Hypoxia of various degrees was found at any time of the investigation, verified by a low venous oxygen saturation, high 2,3-DPG concentration and an erythrocytosis. The 2,3-DPG concentration was always elevated (preoperatively 18.2 +/- 1.8 muMol/g Hb; postoperatively 1st till 14th day 19.0 +/- 2.2; after 21 months 16.3 +/- 1.2 muMol/g Hb). Preoperatively hypoxia was correlated to the degree of the heart disease expressed by the hight of the Hb-concentration. In contrary after the correction signs of hypoxia (decreased venous oxygen saturation, increased 2,3 DPG-concentration) appeared with a low Hb as found in patients with anemia. The long term check-ups are indicative for slight cardiac residual disorders as there are hypoxic myocardial damage, residual gradients over the right ventricular outlet, reopened VSD's, and ventriculotomy scar tissue. Though the elevated 2,3-DPG-concentration and the consecutive rightward shift of the oxygen saturation curve obviously compensate these cardiac handi-caps as the excellent physical condition of the children shows.
D000293:Adolescent; D001692:Biological Transport; D001784:Blood Gas Analysis; D002648:Child; D002675:Child, Preschool; D004163:Diphosphoglyceric Acids / Q000097:blood; D004912:Erythrocytes / Q000032:analysis; D005260:Female; D006400:Hematocrit; D006454:Hemoglobins; D006801:Humans; D000860:Hypoxia; D008297:Male; D010100:Oxygen; D011183:Postoperative Complications; D013771:Tetralogy of Fallot / Q000601:surgery*; D013997:Time Factors
D004163:Diphosphoglyceric Acids; D006454:Hemoglobins; D010100:Oxygen
Der Einfluss der Korrektur einer Fallotschen Tetralogie auf Sauerstofftransport und Lungenveränderungen). Teil I: Sauerstofftransport