title: Hypoplasia of the left ventricle: rare cause of postoperative mortality in tetralogy of Fallot.
abstract: Severe left ventricular hypoplasia in tetralogy of Fallot is a rare complication. A case history of a 3 year old child who died after attempted repair of tetralogy is presented. Left ventricular end-diastolic volume was 26 ml/m2 (only 45 percent of predicted normal) after repair with normal filling pressure and no evidence of tamponade. Clinical examination, chest X-ray film, electrocardiogram and qualitative assessment of a preoperative left ventriculogram were not useful in assessing this degree of left ventricular hypoplasia; quantitative determination of left ventricular volumes is required for this purpose. When left ventricular end-diastolic volume is less than 55 percent of predicted normal, a shunt procedure may be indicated as an initial procedure with subsequent repair 1 to 2 years later, after left ventricular enlargement.
mesh_terms: D002675:Child, Preschool; D006330:Heart Defects, Congenital / Q000150:complications; D006352:Heart Ventricles / Q000002:abnormalities*; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000209:etiology*; D013771:Tetralogy of Fallot / Q000150:complications / Q000601:surgery*