Abstract
Pre- and postoperative echocardiographic right ventricular wall thickness (RVW), transverse dimension (RVD), and their ratio (W/D) were measured from subcostal views in 29 patients with Tetralogy of Fallot (TOF) in order to assess whether primary reparative surgery without prior palliative shunts in early infancy results in significantly faster regression of RV hypertrophy than repair later in life.
Fourteen patients who were repaired before 6 months of age were compared with 15 patients who were repaired after 6 months of age. In the group of patients who were repaired before 6 months of age both RVW and W/D ratio decreased significantly whereas RVD did not change from pre- to postoperative status. The group of patients who were repaired after 6 months of age showed no significant changes in RVW, RVD, or W/D ratio.
These findings suggest that early primary reparative surgery of TOF may have a positive effect on faster regression of RVH during the first postoperative year which may reduce the detrimental effect of longstanding hypertrophy on myocardial function and the potential for arrhythmia.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Castaneda AR, Freed MD, Williams RG, Norwood WI (1977) Repair of tetralogy of Fallot in infancy.J Thorac Cardiovasc Surg 74:372–379
Deanfield JE, Ho Sy, Anderson RH, McKenna WJ, Allwork SP, et al. (1983) Late sudden death after repair of tetralogy of Fallot: a clinico pathologic study.Circulation 67:626–631
Deanfield JE, McKenna WJ, Presbitero P, England D, Graham GR, et al. (1984) Ventricular arrhythmia in unrepaired and repaired tetralogy of Fallot: relation to age, timing of repair and hemodynamic status.Br Heart J 52:77–81
Deanfield J, McKenna W, Rowland E (1985) Local abnormalities of right ventricular depolarization after repair of tetralogy of Fallot: a basis for ventricular arrhythmia.Am J Cardiol 55:522–525
Gustafson RA, Murray GF, Warden HE, Hill RC, Rozar GE (1988) Early primary repair of tetralogy of Fallot.Ann Thorac Surg 45:235–241
Jones M, Ferrans VJ (1977) Myocardial degeneration in congenital heart disease: comparison of morphologic findings in young and old patients with muscular obstruction to right ventricular outflow.Am J Cardiol 39:1051–1063
Kirklin JW, Blackstone EH, Jones RA, Shimazakiy, Kirklin JK, et al. (1992) Morphologic and surgical determinants of outcome events after repair of tetralogy of Fallot and pulmonary stenosis.J Thorac Cardiovasc Surg 103:706–723
Lev M, Rimoldi HJA, Rowlatt UF (1964) The quantitative anatomy of cyanotic tetralogy of Fallot.Circulation 301:531
Sullivan I, Presbitero P, Gooch VM, Aruta E, Deanfield J (1987) Is ventricular arrhythmia in repaired tetralogy of Fallot an effect of operation or a consequence of the course of the disease?Br Heart J 58:40–44
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Seliem, M.A., Wu, Y.T. & Glenwright, K. Relation between age at surgery and regression of right ventricular hypertrophy in tetralogy of Fallot. Pediatr Cardiol 16, 53–55 (1995). https://doi.org/10.1007/BF00796817
Issue Date:
DOI: https://doi.org/10.1007/BF00796817