Postoperative long-term results in total correction of tetralogy of Fallot: hemodynamics and cardiac function.
Late results were assessed in 63 patients who underwent complete repair of tetralogy of Fallot. These patients were divided into four groups. Group I-A included 13 who had a transannular patch with a monocusp, and whose cross-sectional area index (CSAI) was less than 2.5 cm2/m2; group I-B included 11 with the patch and with a CSAI greater than 2.5 cm2/m2. Group II included 27 patients who underwent pulmonary valvotomy. Group III included 9 who had not undergone valvotomy and 3 who had undergone pulmonary valve replacement. Late death occurred in 1 patient, and reoperation was done on 3. Mild pulmonary stenosis (PS) was present in 73%, moderate PS in 17%, and severe PS in 10% of the patients. A significant pulmonary regurgitation (PR) of grade 3 or 4 was present in 33% of the patients in group I-A, and in 87% of group I-B, 17% of group II, and 0% of group III. Right ventricular end-diastolic volume was normal in patients with a PR of grade 2 or less, and it was higher in patients who had a significant PR. The ejection fraction was generally decreased, regardless of the grade of PR. Left ventricular function was normal in those with a PR of grade 3 or less and was impaired in those with a PR of grade 4. Thus, late postoperative hemodynamics and ventricular function were excellent in patients with a mild PS and a PR of grade 2 or less and it was poor in those with a moderate PS and a significant PR.(ABSTRACT TRUNCATED AT 250 WORDS)
D000293:Adolescent; D000328:Adult; D002306:Cardiac Volume; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D006321:Heart / Q000503:physiopathology*; D006439:Hemodynamics; D006801:Humans; D007223:Infant; D008722:Methods; D011665:Pulmonary Valve Insufficiency / Q000209:etiology; D011666:Pulmonary Valve Stenosis / Q000209:etiology; D012086:Reoperation; D013318:Stroke Volume; D013771:Tetralogy of Fallot / Q000150:complications / Q000503:physiopathology / Q000601:surgery*