Short-term variations of the right ventricular/left ventricular pressure ratio following repair of tetralogy of fallot.
In 50 consecutive patients undergoing repair of tetralogy of Fallot, the peak systolic right ventricular/left ventricular pressure ratio (pRV/LV) was measured prospectively in the operating room and in the third postoperative week in order to assess its eventual short-term variations. Postoperatively, the ratio fell in 64% of the patients, remained unchanged in 6%, and increased in 30%. The mean postoperative pRV/LV ratio for the group as a whole showed a small but statistically significant fall with respect to the mean operating room pRV/LV ratio (0.47 [standard deviation] +/- 0.16 and 0.52 +/- 0.12, respectively; mean difference, -0.05; p value for the significance level of difference, 0.004). A separate analysis of patients in whom the right ventricular outflow tract was reconstructed with (N = 12) or without (N = 38) a transannular patch showed essentially the same results. Nevertheless, the difference between the pRV/LV ratio measured in the operating room and three weeks postoperatively is not significant in the group with a transannular patch because of the small number of patients. These data corroborate that the pRV/LV ratio measured in the operating room immediately after repair of tetralogy of Fallot reflects closely the postoperative ratio, being slightly higher by an average of 10%, is expected to fall shortly after operation in almost two-thirds of the patients, and is a useful variable in intraoperative decision making and in predicting the surgical result.
D001794:Blood Pressure; D002648:Child; D006352:Heart Ventricles; D006801:Humans; D011184:Postoperative Period; D013771:Tetralogy of Fallot / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors