Document Detail


Influence of the pulmonary annulus diameter on pulmonary regurgitation and right ventricular pressure load after repair of tetralogy of Fallot.
MedLine Citation:
PMID:  12381646     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess the influence of the pulmonary annulus diameter after reconstruction of the right ventricular (RV) outflow tract at repair of tetralogy of Fallot on pulmonary regurgitation and RV pressure load; and to evaluate the impact of pulmonary regurgitation on RV size and function. SETTING: Paediatric cardiology and diagnostic radiology departments of a tertiary referral centre. PATIENTS: 67 patients were examined at a median of 4.8 years after repair of tetralogy of Fallot by means of biplane angiocardiography and magnetic resonance imaging (MRI). MAIN OUTCOME MEASURES: Pulmonary annulus diameter and area, pulmonary regurgitant fraction, RV to left ventricular (LV) systolic pressure ratio, RV end diastolic volume, and RV ejection fraction were assessed. RESULTS: There was a significant positive correlation between pulmonary annulus area indexed to body surface area and pulmonary regurgitation (angiocardiography: r = 0.55, p < 0.001; MRI: r = 0.59, p < 0.001). No significant correlation was found between pulmonary annulus index and RV to LV systolic pressure ratio even in patients with small pulmonary annulus areas (r = -0.24, NS). Pulmonary regurgitant fraction was positively correlated with normalised RV end diastolic volume (angiocardiography: r = 0.42, p < 0.05; MRI: r = 0.56, p < 0.01). RV ejection fraction decreased with increasing pulmonary regurgitation (angiocardiography: r = -0.42, p < 0.05; MRI: r = -0.41, p < 0.05). CONCLUSIONS: The extent of pulmonary regurgitation after tetralogy of Fallot repair correlates with the postoperative size of the pulmonary annulus and is closely correlated with the enlargement of the RV. An enlargement of the pulmonary annulus to the second lower standard deviation of normal results in a decrease of pulmonary regurgitation and is sufficient to achieve adequate RV pressure unloading.
Authors:
A Uebing; G Fischer; M Bethge; J Scheewe; F Schmiel; J Stieh; J Brossmann; H H Kramer
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  88     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2002 Nov 
Date Detail:
Created Date:  2002-10-16     Completed Date:  2002-12-09     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  510-4     Citation Subset:  AIM; IM    
Affiliation:
Department of Paediatric Cardiology, Christian-Albrechts University of Kiel, Kiel, Germany. uebing@pedcard.uni-kiel.de
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Angiocardiography / methods
Blood Pressure / physiology
Child
Child, Preschool
Humans
Infant
Magnetic Resonance Angiography / methods
Pulmonary Valve / pathology*
Pulmonary Valve Insufficiency / etiology*,  pathology,  physiopathology
Tetralogy of Fallot / pathology*,  physiopathology,  surgery
Ventricular Dysfunction, Right / pathology,  physiopathology
Comments/Corrections
Comment In:
Heart. 2002 Nov;88(5):447-8   [PMID:  12381626 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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