Assessment of right ventricular function after surgical repair of tetralogy of Fallot
Abstract
Objectives: to investigate influence of the main anatomical components of the RV on global RV function by using CMRI after different surgical approaches of TOF repair. Methods: 52 asymptomatic, clinically stable patients were investigated after TOF repair in age of 7.5 (5.5; 9.5) years old to assume RV dysfunction at the NRICP pediatric cardiac surgery department. All patients were divided in 2 groups depending on surgery technique of TOF repair: transannular plasty (1 group, 26 pts) or with pulmonary annulus preservation (2 group, 26 pts). Results: Ejection fraction of the RV in common and separately were significantly higher in 2 group, while RVEDV in common and separately and SV were increased in 1 group. Pulmonary regurgitation also were higher in 1 group 36.7 (32;44) versus 13,2 (3;14) (p > 0,01). Odds ration for pulmonary regurgitation were lower in 2 group in comparison with 1 group, OR (95 % confidence interval, CI) 0.19 (0.04–0.72), р = 0,02. Conclusions: RV function after TOF repair depends on the kind of RVOT reconstruction. Through separate functional analysis of the anatomical RV components, this study has demonstrated that the global RV function is commonly depressed after transannular plasty. Long-term RV dysfunction in group with transannular plasty is associated with significant pulmonary regurgitation and large akinetic RVOT region, involving the sinus part in contractile properties.
Key words
ReferencesOmelchenko A.Yu. – candidate of medical sciences, cardio-vascular surgeon of cardio-surgical department of congenital heart disorders, researcher of center for novel surgical technologies
Gorbatykh Yu.N. – doctor of medical sciences, professor, head of department of congenital heart disorders
Soinov I.A. – research assistant of center for novel surgical technologies
Voitov A.V. – cardio-vascular surgeon of cardio-surgical department of congenital heart disorders, researcher of center for novel surgical technologies
Kulyabin Yu.Yu. – clinical attending physician on cardio-vascular surgery
Kornilov I.A. – candidate of medical sciences, anethesiologist of department for anesthesiology and reanimation, senior researcher of center for anesthesiology and reanimation
Gorbatykh A.V. – candidate of medical sciences, cardio-vascular surgeon of cardio-surgical department of congenital heart disorders, researcher of center for novel surgical technologies
Bogachev-Prokofiyev A.V. – doctor of medical sciences, head researcher of center for novel surgical technologies
