[Long term hemodynamic results following complete cure of Fallot's tetralogy].
Cardiac catheterisation was carried out on an unselected series of 148 patients who had undergone complete correction of Fallot's tetralogy after an average postoperative period of si and a half years (range 2 to 20 years). 4% residual significant interventricular shunts (Qp/Qs > 1.3), 11% residual stenosis on the infundibulo-pulmonary tract (gradient greater than or equal to 10 mmHg) and 60% pulmonary incompetence was found. These findings do not reflect the excellent clinical results. All patients had normal lives: 89% remain asymptomatic since their operation and symptoms in the other patients are limited to moderate dyspnoea on effort or to arrhythmias which are usually periodic. A synthesis of the clinical and haemodynamic data shows that only a quarter of patients may be considered to be cured, that although the surgical results in 2/3 patients are not perfect, they are satisfactory, and that the results of complete correction in the remaining 12% are poor. The results do not appear to be related to the age at which correction was performed or to previous palliative surgery. On the other hand, the long-term haemodynamic results were related to the surgical method of infundibulo-pulmonary repair. Systolic right ventricular pressures of over 60 mmHg recorded at the end of operation in 33 patients, had returned to normal in 76% cases. These results suggest that the indications for prosthetic remodeling of the infundibulo-pulmonary tract should be increased, although this does not always prevent residual stenosis.
D000293:Adolescent; D000328:Adult; D001157:Arterial Occlusive Diseases / Q000175:diagnosis; D001794:Blood Pressure; D006332:Cardiomegaly / Q000175:diagnosis; D002648:Child; D002675:Child, Preschool; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008134:Long-Term Care; D008168:Lung; D008297:Male; D008875:Middle Aged; D019736:Prostheses and Implants; D011651:Pulmonary Artery / Q000503:physiopathology; D011665:Pulmonary Valve Insufficiency / Q000175:diagnosis; D013771:Tetralogy of Fallot / Q000601:surgery*
Résultats hémodynamiques lointains après cure radicale de la tétralogie de Fallot.