Why the study?
Does corrective surgery at age <4 years compared to >4 years preserve postoperative ventricular function in patients with tetralogy of Fallot?
Does corrective surgery at age <4 years compared to >4 years preserve postoperative ventricular function in patients with tetralogy of Fallot?
Corrective surgery for tetralogy of Fallot before 4 years of age may better preserve ventricular function under stress compared to later surgery.
May favor TOF repair before age 4 to preserve stress ventricular function; hypothesis-generating and requires prospective confirmation before practice change.
Age-related changes in right (RV) and left (LV) ventricular myocardium in tetralogy of Fallot (TF) are analyzed with regard to pre- and postoperative ventricular function. In RV, preoperative function was better in patients under 4 years of age in terms of ejection fraction and compliance, but no significant change was seen in LV function. Postoperatively, patients who underwent corrective surgery at age less than 4 years showed no significant difference compared to those at operative age above 4 years in terms of RV and LV functions at rest. However, stress tests for RV by isoproterenol and LV using methoxamine revealed some masked ventricular dysfunction in both ventricles in the older groups. The relationships between these functional abnormalities and previously described histological changes of right and left ventricular myocardium in TF are discussed.
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Matsuda et al. (1986) studied this question.
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