Radical repair of tetralogy of Fallot was associated with systolic and diastolic right ventricular abnormalities, with reduced ejection fraction primarily reflecting impaired contractile function.
Observational (n=24)
What are the effects of radical surgical repair of tetralogy of Fallot on right ventricular function and pulmonary regurgitation?
Following radical repair of tetralogy of Fallot, patients exhibit systolic and diastolic right ventricular abnormalities, with reduced ejection fraction primarily reflecting intrinsic contractile impairment rather than the degree of pulmonary regurgitation.
Biplane right ventriculograms with simultaneous high fidelity pressure recordings were obtained in 24 patients with tetralogy of Fallot. Twelve patients were studied before repair and 12 were studied 67 (42) months after radical surgical repair without the use of a transannular patch. In the patients who had repair right ventricular end diastolic and end systolic volume indices were higher, and the ejection fraction was lower. Time to peak ventricular filling and the peak rate of ventricular fillings were also lower in this group and there was a significant relation between peak filling rate and ejection fraction. Postoperative pressure-volume loops from nine patients showed an increase in cavity volume during the decline in right ventricular pressure, which indicated pulmonary regurgitation. The mean regurgitant volume for the group correlated with end diastolic volume index, stroke volume index, and peak filling rate, but not with ejection fraction. These data show that both systolic and diastolic abnormalities of right ventricular function are detected in most patients after radical repair of tetralogy of Fallot. The reduction of ejection fraction previously reported in these patients is unrelated to the degree of pulmonary regurgitation and primarily reflects an impairment of contractile function that presumably is related to intraoperative events.
Redington et al. (1988) conducted an observational in Tetralogy of Fallot (n=24). Radical surgical repair without transannular patch vs. Before repair was evaluated on Right ventricular function and pulmonary regurgitation. Radical repair of tetralogy of Fallot was associated with systolic and diastolic right ventricular abnormalities, with reduced ejection fraction primarily reflecting impaired contractile function.