Abstract
Pulmonary insufficiency(PI) has been implicated in the etiology of ventricular arrhythmias(VA) and biventricular dysfunction after Tetralogy of Fallot repair. To assess this, 30 consecutive postoperative TF pts with clinical PI have undergone branch pulmonary(PA) injections at follow-up catheterization. Group I consisted of 13 pts who cleared contrast normally from the right heart, within 2 beats of injection; Group II consisted of 17 pts who required 3-11 beats (x̄=6) to clear the right heart. The groups did not differ significantly in age at surgery or evaluation, RV hypertension or RV outflow tract gradient. Five of 13 pts in Group I and 12/17 in Group II had obligatory surgical PI. The groups were compared for RV size by M-mode echocardiography expressed as RV/LV ratio diastolic dimension, RV and LV ejection fractions by radionuclide ventriculography, and grade of VPCs detected on treadmill exercise and ambulatory ECG. Findings are summarized below:
In this study, prolonged opacification of the right heart after branch PA injection correlated with significant right ventricular dilatation, biventricular dysfunction, and ventricular ectopy After TF repair, branch PA injections provide a useful method for assessing the variable impact of pulmonary insufficiency.
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Kavey, RE., Schneider, B., Sondheimer, H. et al. ANGIOGRAPHIC ASSESSMENT OF THE IMPACT OF PULMONARY INSUFFICIENCY AFTER TETRALOGY OF FALLOT REPAIR. Pediatr Res 18 (Suppl 4), 124 (1984). https://doi.org/10.1203/00006450-198404001-00186
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DOI: https://doi.org/10.1203/00006450-198404001-00186