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Showing 3 results for Tetralogy of Fallot
Echocardiographic ventricular function evaluation in pulmonary valve insufficiency after surgical repair of Fallot tetralogy
Aarabi M.u, Meraji M, Mortezaeian H,
Volume 65, Issue 4 (7-2007)
Abstract
Background: Tetralogy of Fallot is the most common cyanotic congenital heart disease. The systolic and diastolic function in both ventricles is altered even after successful corrective surgery for this defect with a transannular patch. Pulmonary regurgitation, a common complication after this treatment, is usually well tolerated in childhood. The aim of this study was to assess the combined diastolic and systolic function of both ventricles using the Doppler-derived myocardial performance index (Tei index) in patients who underwent surgical repair of tetralogy of Fallot using a transannular patch. In this article we discuss the impact of pulmonary regurgitation on right ventricular function and clinical outcome, the role of echocardiographic imaging, and current management strategies for patients with pulmonary regurgitation after this treatment.
Methods: Sixty eight patients with tetralogy Fallot were studied in Shahid Rajaie referral Cardiovascular Center during 2003-2005. The studied population, 36 male and 32 female with a mean age of 7.5±4 years and a history of corrective surgery for tetralogy of Fallot using a transannular patch. These patients were randomly selected and assessed by Doppler echocardiography.
Results: Fifty-seven patients (84%) had mild to moderate pulmonary regurgitation, whereas 11 patients (16%) had severe pulmonary regurgitation. Right ventricular Tei index was significantly increased in patients with severe pulmonary regurgitation compared those with mild to moderate pulmonary regurgitation (0.54±0.18 vs 0.24±0.11, P<0.01). Left ventricular Tei index was increased in patients with severe pulmonary regurgitation compared those with mild to moderate pulmonary regurgitation (0.46±0.22 vs 0.32±0.14, P<0.05).
Conclusions: The findings of this study suggest that pulmonary regurgitation is a serious complication after repair of tetralogy of Fallot with a transannular patch. Delaying surgery in such patients risks irreversible ventricular function.
Mid-term results of pulmonary valve replacement in patients with total correction of Tetralogy of Fallot in Rajaei Heart Center, Tehran, Iran
Alizadeh Sani Z, Farhang I, Kiyavar M,
Volume 69, Issue 9 (12-2011)
Abstract

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: The aim of this study was to evaluate the mid-term outcomes of concurrent total correction of Tetralogy of Fallot (TOF) after pulmonary valve (PV) replacement and its relation to QRS duration and MRI results.
Methods:  In this study, 51 patients with TOF who had the TOF surgery and PV replacement enrolled the study. Demographic data, MRI results such as, right ventricular end diastolic volume, right ventricular end systolic volume, systolic and diastolic indexes noted. Moreover, QRS duration and the patients' cardiac functional class were evaluated immediately before and 6 months after the surgery.
Results:  From 51 patients, 27.5% were female and 72.5% were male. The mean age of participants was 23.48 (SD=5.82) years. Functional class changes were statistically different (P<0.001) comparing the status before and after the surgery. The mean QRS duration before surgery was 130.20 (SD=16.89) ms which was in significant contrast with post-surgical states, 122.45 (SD=16.90) ms (P<0.001). Mean QRS duration before and after surgery was statistically lower in asymptomatic patients (P=0.028 and P=0.025, respectively). There was a statistical relationship between pre-surgical systolic and diastolic indexes to post-surgical functional class as asymptomatic patients had lower systolic and diastolic indexes (P=0.005 and P=0.028, respectively).
Conclusion: This study demonstrated that QRS duration before and after surgery can be an indicator to evaluate the cardiac function after surgery for Tetralogy of Fallot. Moreover, systolic and diastolic indexes are factors affecting the good prognosis of patients therefore, PVR surgery needs to be done before the deterioration of systolic and diastolic indexes and cardiomegaly.


Mitral valve Z value in Iranian patients with tetralogy of Fallot
Manouchehr Hekmat , Hamid Ghaderi , Seyedeh Adeleh Mirjafari , Shahram Rajaei Behbahani , Mehran Shahzamani , Gholamreza Masoumi ,
Volume 75, Issue 9 (12-2017)
Abstract
Background: Tetralogy of Fallot (TOF) refers to a condition in which left ventricular volume is normal or slightly less than normal. Given the differences observed in some Asian patients with TOF, the present study was conducted to investigate left heart by determining Z-scores for the mitral valve in Iranian patients with TOF.
Methods: Eligible subjects in this prospective descriptive study comprised all patients with TOF presenting to Shahid Modarres Hospital in Tehran from March 2012 to March 2015 and diagnosed as the candidates for surgery. After determining the need for surgery and the therapeutic method required, the mitral valve size and Z-scores were calculated. We analyzed sex, age, body surface area (BSA), mitral size (in 2-chamber and 4-chamber view), mitral Z-score, other cardiac anomalies, number of surgery and previous surgery.
Results: Of a total of 80 patients included in the study over 3 years, 29 (36.3%) were male and 51 (63.8%) were female. The mean age of the patients was 7.15±3.37 years and their mitral size was found to be 10-27 mm (16.2±5.99 mm) using echocardiography. Z-scores of the mitral valve were also obtained as -3.09±2.11, ranging between -7.1 SD and +1.3 SD. 58 (72.5%) patients have only TOF and 22 (27.5%) with other cardiac anomalies. 45 patients were for first time underwent surgery and 22 patients for second time, 12 patients for three time and 1 for forth. Of a total of 35 patients had previous surgery, the most common were shunt 15 (42.9%) and then tetralogy of Fallot total correction (TFTC) in 12 (34.3%). Of a total of 80 patients, 59 (73.8%) underwent TFTC, 17 (21.3%) under pulmonary valve replacement and 4 (5%) shunt.
Conclusion: Z-scores of the mitral valve were found to be significantly below the normal value, (i.e. 0±2 SD), in the study patients, suggesting the risk of hypoplastic left heart syndrome in Iranian patients with TOF, nevertheless, the type of TOF examined in these patients might have been different from those observed in other races and regions.
 

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