Pediatric Cardiology

, Volume 10, Issue 1, pp 25–31 | Cite as

Radionuclide evaluation of right ventricular wall motion after surgery in tetralogy of Fallot

  • Osman Ratib
  • Beat Friedli
  • Alberto Righetti
  • Ingrid Oberhaensli
Article

Summary

Regional wall motion patterns in tetralogy of Fallot and its postoperative modifications by electrical and hemodynamic factors were assessed by Fourier analysis of gated radionuclide angiograms in 24 studies performed in children after surgical correction of tetralogy of Fallot. The range of right ventricular (RV) phase angles (standard deviation of the peak [SDP] of RV) as well as the difference between RV and LV (ΔMPh) were used as indices of the synchronicity of wall motion and were correlated with RV apical electrical activation time determined by endocardial electrical mapping. Postoperative studies were divided into two groups according to apical activation: (a) those involving right bundle branch block (RBBB) (nine patients), and (b) those involving distal RBBB (15 patients). ΔMPh was longer in proximal than in distal RBBB. Best discrimination between the two groups was obtained with SDP of RV (proximal=24°±3°, and distal=17°±2°;p<0.0001). These results showed that the range of ventricular phases measured by the SD of the phase distribution of the right ventricle is a good index for distinguishing between proximal and distal RBBB after cardiac surgery.

Key words

Phase analysis Radionuclide angiography Tetralogy of Fallot Right bundle branch block 
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References

  1. 1.
    Adam WE, Tarkowska A, Bitter F, Stauch M, Geffers H (1979) Equilibrium (gated) radionuclide ventriculography.Cardiovasc Radiol 2:161–173PubMedGoogle Scholar
  2. 2.
    Deanfield J, Sugrue D, McKenna W, Rowland E, Hallidie-Smith K, Lavender P, Oakley C (1982) Regional right ventricular function in post operative tetralogy of Fallot: assessment by endocardial mapping and phase imaging of krypton-81M radionuclide angiograms [abstr].Circulation 66(II):360Google Scholar
  3. 3.
    Friedli B (1986) Prognostic significance of ventricular conduction abnormalities and extrasystoles after open heart surgery. In: Becker AE, Losekoot G, Marcelletti C, Anderson RH (eds)Paediatric cardiology, vol 3. Churchill Livingstone, Edinburgh, pp 150–159Google Scholar
  4. 4.
    Friedli, B, Bolens M (1985) Intraventricular conduction disturbances after correction of tetralogy of Fallot: can the surface ECG diagnose bifascicular and trifascicular block?Pediatr Cardio 6:133–136.Google Scholar
  5. 5.
    Gelband H, Waldo AL, Kaiser GA, Browman FO, Malm JR, Hoffman BF (1971) Etiology of right bundle branch block in patients undergoing total correction of tetralogy of Fallot.Circulation 44:1022–1033PubMedGoogle Scholar
  6. 6.
    Horowitz LN, Alexander JA, Edmunds LH (1980) Postoperative right bundle branch block: identification of three levels of block.Circulation 62:319–328PubMedGoogle Scholar
  7. 7.
    Hurwitz R, Treves S, Freed M, Girod D, Caldwell R (1983) Quantitation of aortic and mitral regurgitation in the pediatric population: evaluation by radionuclide angiocardiography.Am J Cardiol 51:252–255PubMedGoogle Scholar
  8. 8.
    Kulbertus HE, Coyne JJ, Hallidie-Smith KA (1969) Conduction disturbances before and after surgical closure of ventricular septal defect.Am Heart J 77:123–130CrossRefPubMedGoogle Scholar
  9. 9.
    Links JM, Douglass KH, Wagner HN (1980) Patterns of ventricular emptying by Fourier analysis of gated blood-pool studies.J Nucl Med 21:978–982PubMedGoogle Scholar
  10. 10.
    Parrish M, Graham T, Born M, Jones J (1982) Radionuclide evaluation of right and left ventricular function of children: validation and methodology.Am J Cardiol 49:1241–1247PubMedGoogle Scholar
  11. 11.
    Ratib O, Henze E, Schon H, Schelbert HR (1982) The value of phase analysis of radionuclide angiograms for the detection of coronary artery disease.Am Heart J 104:1–8CrossRefPubMedGoogle Scholar
  12. 12.
    Slutsky RA (1983) Radionuclide evaluation of cardiocirculatory performance at rest and with exercise.Cardiol Clin 1:441–455PubMedGoogle Scholar
  13. 13.
    Steeg CN, Krongrad E, Davachi F, Browman FO, Malm JR, Gersony WM (1975) Postoperative left anterior hemiblock and right bundle branch block following repair of tetralogy of Fallot.Circulation 51:1026–1029PubMedGoogle Scholar
  14. 14.
    Sung RJ, Tamer DM, Garcia OL, Castellanos A, Myerburg RJ, Gelband H (1976) Analysis of surgically induced right bundle branch block pattern using intracardiac recording techniques.Circulation 46:23–27Google Scholar
  15. 15.
    Takeda K, Maeda H, Yamaguchi N, Nakagawa T, Taguchi M (1982) Right ventricular emptying performance in congenital heart disease assessed by temporal Fourier analysis of gated blood study.Proc World Cong Nucl Med Biol 1:408–411Google Scholar
  16. 16.
    Treves ST, Newberger J, Hurwitz R (1985) Radionuclide angiocardiography in children.JACC 5:120s-127sPubMedGoogle Scholar
  17. 17.
    Vetter V, Horowitz L (1983) Electrophysiologic residua and sequelae of surgery for congenital heart defects. In: Engle M, Perloff J (eds)Congenital heart disease after surgery. Yorke Med Books, pp 261–305Google Scholar

Copyright information

© Springer-Verlag New York Inc 1989

Authors and Affiliations

  • Osman Ratib
    • 1
  • Beat Friedli
    • 1
  • Alberto Righetti
    • 1
  • Ingrid Oberhaensli
    • 1
  1. 1.Cardiology Center and Pediatric Cardiac Unit, Department of PediatricsGeneva University HospitalSwitzerland

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