Optimal timing for pulmonary valve replacement in adults after tetralogy of Fallot repair.
The timing of pulmonary valve replacement in adult patients with repaired tetralogy of Fallot remains controversial. A magnetic resonance imaging study in 17 adult patients with repaired tetralogy of Fallot reveals a statistically significant decrease in right ventricular (RV) volume (RV end-diastolic volume 163 +/- 34 to 107 +/- 26 ml/m2, p <0.001; RV end-systolic volume 109 +/- 27 to 69 +/- 22 ml/m2, p <0.001) at a mean follow-up of 21 months after pulmonary valve replacement; whereas RV systolic function remained unchanged (mean RV ejection fraction 32 +/- 7% to 34 +/- 10%, p = 0.12). In no patients with a RV end-diastolic volume >170 ml/m2 or a RV end-systolic volume >85 ml/m2 before pulmonary valve replacement were RV volumes "normalized" after surgery.
Therrien
Judith
J
Toronto Congenital Cardiac Centre for Adults, Toronto, Ontario, Canada. jtherrien@cardio.jgh.mcgill.ca
Provost
Yves
Y
Merchant
Naeem
N
Williams
William
W
Colman
Jack
J
Webb
Gary
G
D000328:Adult; D002306:Cardiac Volume / Q000502:physiology; D003971:Diastole / Q000502:physiology; D004452:Echocardiography; D018618:Echocardiography, Doppler, Color; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000503:physiopathology / Q000601:surgery*; D011664:Pulmonary Valve / Q000503:physiopathology / Q000601:surgery*; D011665:Pulmonary Valve Insufficiency / Q000503:physiopathology / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D013318:Stroke Volume / Q000502:physiology; D013599:Systole / Q000502:physiology; D013771:Tetralogy of Fallot / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D016278:Ventricular Function, Right / Q000502:physiology