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Preservation of the pulmonary annulus in total correction of tetralogy of Fallot. Decreasing transannular gradients in the early follow-up period

Preservation of the pulmonary annulus in total correction of tetralogy of Fallot. Decreasing... AbstractThe integrity of the pulmonary annulus was preserved in 21 of 22children consecutively subjected to total correction of tetralogy ofFallot. There was one early death (4.8%). The 20 survivors were studiedprospectively and constitute the basis of this report. Mean age was 59.3+/- 35.3 months (range 6 months-12 years). Eight patients (40%) hadprevious Blalock-Taussig shunts and 3 (15%) had associated cardiacanomalies. Two-dimensional Doppler echocardiography had demonstrated rightventricle to main pulmonary artery peak systolic gradients of 75.4 +/- 12.7mmHg (range 50-104 mmHg). Ventricular infundibulectomy was carried out inall patients but one, who had abnormal coronary anatomy. Extensive incisionor resection of hypertrophied or abnormal muscle bands was performed.Pulmonary valve commissurotomy was performed in 14 patients (70%), 10 (50%)had autologous pericardium supravalvular enlargement of the pulmonary trunkand one (5%) had an infundibular bovine pericardial patch. Intraoperative,postrepair right/left ventricular pressure ratios were 0.67 +/- 0.18 (range0.41- 1.0). All ratios were accepted, because all patients werehaemodynamically well and only two required inotropic (dopamine) support.There was no late mortality. During the early follow-up period (mean 13.0+/- 5.4 months, range 7-25 months), all patients had two- dimensionalDoppler echocardiography measured gradients at discharge (mean 44.2 +/-22.6 mmHg, range 10-86 mmHg; p less than 0.001 vs. preoperative values), at3 months (mean 31.1 +/- 14.5 mmHg, range 8-64 mmHg; p less than 0.011 vs.values at discharge) and at 6 months (mean 28.5 +/- 14.3 mmHg, range 12-57mmHg; p = 0.009 vs. values at discharge). A similar favourable evolution ofthe diameters of the pulmonary annulus and of the right pulmonary arterywas observed.(ABSTRACT TRUNCATED AT 250 WORDS) http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png European Journal of Cardio-Thoracic Surgery Oxford University Press

Preservation of the pulmonary annulus in total correction of tetralogy of Fallot. Decreasing transannular gradients in the early follow-up period

European Journal of Cardio-Thoracic Surgery , Volume 5 (10) – Oct 1, 1991
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Publisher
Oxford University Press
Copyright
© Springer-Verlag 1991
ISSN
1010-7940
eISSN
1873-734X
DOI
10.1016/1010-7940(91)90106-T
Publisher site
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Abstract

AbstractThe integrity of the pulmonary annulus was preserved in 21 of 22children consecutively subjected to total correction of tetralogy ofFallot. There was one early death (4.8%). The 20 survivors were studiedprospectively and constitute the basis of this report. Mean age was 59.3+/- 35.3 months (range 6 months-12 years). Eight patients (40%) hadprevious Blalock-Taussig shunts and 3 (15%) had associated cardiacanomalies. Two-dimensional Doppler echocardiography had demonstrated rightventricle to main pulmonary artery peak systolic gradients of 75.4 +/- 12.7mmHg (range 50-104 mmHg). Ventricular infundibulectomy was carried out inall patients but one, who had abnormal coronary anatomy. Extensive incisionor resection of hypertrophied or abnormal muscle bands was performed.Pulmonary valve commissurotomy was performed in 14 patients (70%), 10 (50%)had autologous pericardium supravalvular enlargement of the pulmonary trunkand one (5%) had an infundibular bovine pericardial patch. Intraoperative,postrepair right/left ventricular pressure ratios were 0.67 +/- 0.18 (range0.41- 1.0). All ratios were accepted, because all patients werehaemodynamically well and only two required inotropic (dopamine) support.There was no late mortality. During the early follow-up period (mean 13.0+/- 5.4 months, range 7-25 months), all patients had two- dimensionalDoppler echocardiography measured gradients at discharge (mean 44.2 +/-22.6 mmHg, range 10-86 mmHg; p less than 0.001 vs. preoperative values), at3 months (mean 31.1 +/- 14.5 mmHg, range 8-64 mmHg; p less than 0.011 vs.values at discharge) and at 6 months (mean 28.5 +/- 14.3 mmHg, range 12-57mmHg; p = 0.009 vs. values at discharge). A similar favourable evolution ofthe diameters of the pulmonary annulus and of the right pulmonary arterywas observed.(ABSTRACT TRUNCATED AT 250 WORDS)

Journal

European Journal of Cardio-Thoracic Surgery – Oxford University Press

Published: Oct 1, 1991

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