<Originals>Right and left ventricular functions following surgical repair of tetralogy of Fallot
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Right and left ventricular functions were assessed by an angiocardiographic method in Japanese children with tetralogy of Fallot before (n=54) and after (n=55) surgical repair. The results were analysed with regard to the relative contribution of preoperative, intraoperative and postoperative factors to postoperative abnormalities in functions. In the early postoperative period (one to two months after corrective surgery), right and left ventricular ejection fractions were significantly depressed. Right ventricular ejection fraction inversely correlated with aortic cross-clamp time (r=-0.66,p<0.01). Left ventricular ejection fraction correlated with preoperative left ventricular ejection fraction (r=0.49,p<0.05). In the late postoperative period (a mean of 4.8 years after corrective surgery), right ventricular ejection fraction was further decreased, in association with increased right ventricular end-diastolic volume. Both the parameters correlated well with the degree of pulmonary regurgitation (p<0.01). Right ventricular ejection fraction in patients with residual right ventricular outflow pressure gradients over 30 mmHg was lower than that in patients with the pressure gradients of 30 mmHg or less. The majority of these residual pressure gradients were at the annulus or central pulmonary artery. Right ventricular ejection fraction in patients with a preoperative aortic oxygen saturation under 80% was significantly lower than that in patients with a preoperative aortic oxygen saturation of 80% or more. The three variables of pulmonary regurgitation, residual pulmonary stenosis, preoperative aortic oxygen saturation were statistically independent. Left ventricular ejection fraction and end-diastolic volume correlated with the right ventricular ejection fraction and end-diastolic volume, respectively (r=0.62,p<0.01,r=0.68,p<0.01). All the other preoperative, intraoperative and postoperative variables did not significantly correlate with the right and left ventricular end-diastolic volumes and ejection fractions. These results show that severe pulmonary regurgitation, significant annular or central pulmonary stenosis and preoperative hypoxia are major contributing facfors to right ventricular dysfunction after the surgical repair of tetralogy of Fallot. The postoperative left ventricular dysfunction is largely attributable to the right ventricular dysfunction.
- 近畿大学の論文
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関連論文
- FACTORS AFFECTING BIVENTRICULAR FUNCTION FOLLOWING SURGICAL REPAIR OF TETRALOGY OF FALLOT
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- Right and left ventricular functions following surgical repair of tetralogy of Fallot