NONINVASIVE ASSESSMENT OF RIGHT AND LEFT-VENTRICULAR VOLUMES 11 TO 24 YEARS AFTER CORRECTIVE SURGERY ON PATIENTS WITH TETRALOGY OF FALLOT

被引：15

作者：

VETTER, HO

REICHART, B

SEIDEL, P

KLEINHANS, E

BULL, U

KLINNER, W

机构：

[1] Department of Cardiovascular Surgery, University of Munich, Munich

[2] Department of Radiology, University of Munich, Munich

[3] Deutsches Herzzentrum Berlin, Berlin 65, D-1000

来源：

EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY | 1990年 / 4卷 / 01期

关键词：

Radionuelide ventriculography; Tetralogy of Fallot; Transannular right ventricular outflow tract patch reconstruction;

D O I：

10.1016/1010-7940(90)90236-S

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Patients who had corrective surgery for tetralogy of Fallot using atransannular right ventricular outflow tract (TRVOT) patch showed a higherrisk of post-operative mortality and reoperation in the long- termfollow-up. A total of 642 patients were operated upon for tetralogy ofFallot between 1952 and 1982. Twenty-six patients who survived for morethan 10 years were selected for this study. Fifteen randomly selectedpatients (group 1) without outflow tract patch were compared with 11patients (group 2) where a transannular right ventricular outflow patch hadbeen used. Right and left ventricular volumes were assessed using combinedfirst-pass and equilibrium radionuclide ventriculography. Afteradministration of 25 mCi of 99mTc- pertechnetate, data were acquired with agamma camera with a large viewing field and the patient at rest and duringexercise. The patients in group 1 were able to manage a workload of 65 ±24 W on the bicycle ergometer while the patients in group 2 could onlyreach a mean maximum of 34 ± 12 W. Right ventricular end-diastolic volume(RV-EDV) at rest was 198 ± 67 ml in group 1 and 224 ± 69 ml in group 2.During exercise, RV-EDV was increased to 218 ± 75 ml in group 1 (P < 0.01) and to 246 ± 79 ml in group 2. Right ventricular end-systolicvolumes did not change significantly during exercise. In group 1, the leftventricular (LV) volumes were comparable to the normal; in group 2, LV-EDV was diminished at rest and during the stress test.In both groups, the ejection fraction (EF) of the right and left ventricle was not changed significantly during exercise except for LV-EF in patients with a TRVOT patch. Therefore, the required increase in cardiac output was achieved mainly by an increased heart rate in group 1 patients, group 1 versus group 2: 73± 12 beats/min vs 76 ± 10 beats/min at rest and 118± 20 beats/min (P < 0.01) vs 98± 23 beats/min (P < 0.05) during exercise. In conclusion, tolerance to exercise in patients with a TRVOT patch is diminished in the long-term follow- up and can easily be detected by a non-invasive radionuclide technique. © Springer-Verlag 1990.

引用

页码：24 / 28

页数：5

共 26 条

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