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Does restrictive right ventricular physiology in the early postoperative period predict subsequent right ventricular restriction after repair of tetralogy of Fallot?
Heart. 1998 May; 79(5):481-4.H

Abstract

OBJECTIVE

To assess the relation between immediate postoperative right ventricular (RV) diastolic physiology and subsequent diastolic function in patients after repair of tetralogy of Fallot.

DESIGN

Serial prospective echocardiographic study early after surgical repair of tetralogy of Fallot and at mid-term follow up.

SETTING

Tertiary referral centre.

PATIENTS

34 patients who had repair of tetralogy of Fallot between 1992 and 1995 were studied.

MAIN OUTCOME MEASURES

Restrictive RV physiology defined as antegrade flow in the pulmonary artery in late diastole throughout the respiratory cycle.

RESULTS

Sixteen of the 34 patients had early restrictive RV physiology. The need for transannular patch repair was an independent variable predictive of early restriction (odds ratio 4.3 (1.1-47), p < 0.05). Nine of 16 patients with early restriction also had restriction at follow up, while 15 of 16 patients without restrictive RV physiology continued without restriction. Early restriction was the only independent variable predictive of late restriction (odds ratio 6.0 (1.9-273), p = 0.01).

CONCLUSIONS

Early and mid-term restrictive RV physiology after repair of tetralogy of Fallot is related to the repair type. Although evidence for this physiology tends to resolve in the first few days after operation, it is highly predictive of subsequent abnormalities of RV diastolic function. Similarly, normal RV diastolic physiology without restriction in the immediate postoperative period persists in the mid-term and may be associated with the long term problems of progressive RV dilatation.

Authors+Show Affiliations

Royal Brompton Hospital, National Heart and Lung Institute, Imperial College, London.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

9659195

Citation

Norgård, G, et al. "Does Restrictive Right Ventricular Physiology in the Early Postoperative Period Predict Subsequent Right Ventricular Restriction After Repair of Tetralogy of Fallot?" Heart (British Cardiac Society), vol. 79, no. 5, 1998, pp. 481-4.
Norgård G, Gatzoulis MA, Josen M, et al. Does restrictive right ventricular physiology in the early postoperative period predict subsequent right ventricular restriction after repair of tetralogy of Fallot? Heart. 1998;79(5):481-4.
Norgård, G., Gatzoulis, M. A., Josen, M., Cullen, S., & Redington, A. N. (1998). Does restrictive right ventricular physiology in the early postoperative period predict subsequent right ventricular restriction after repair of tetralogy of Fallot? Heart (British Cardiac Society), 79(5), 481-4.
Norgård G, et al. Does Restrictive Right Ventricular Physiology in the Early Postoperative Period Predict Subsequent Right Ventricular Restriction After Repair of Tetralogy of Fallot. Heart. 1998;79(5):481-4. PubMed PMID: 9659195.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Does restrictive right ventricular physiology in the early postoperative period predict subsequent right ventricular restriction after repair of tetralogy of Fallot? AU - Norgård,G, AU - Gatzoulis,M A, AU - Josen,M, AU - Cullen,S, AU - Redington,A N, PY - 1998/7/11/pubmed PY - 1998/7/11/medline PY - 1998/7/11/entrez SP - 481 EP - 4 JF - Heart (British Cardiac Society) JO - Heart VL - 79 IS - 5 N2 - OBJECTIVE: To assess the relation between immediate postoperative right ventricular (RV) diastolic physiology and subsequent diastolic function in patients after repair of tetralogy of Fallot. DESIGN: Serial prospective echocardiographic study early after surgical repair of tetralogy of Fallot and at mid-term follow up. SETTING: Tertiary referral centre. PATIENTS: 34 patients who had repair of tetralogy of Fallot between 1992 and 1995 were studied. MAIN OUTCOME MEASURES: Restrictive RV physiology defined as antegrade flow in the pulmonary artery in late diastole throughout the respiratory cycle. RESULTS: Sixteen of the 34 patients had early restrictive RV physiology. The need for transannular patch repair was an independent variable predictive of early restriction (odds ratio 4.3 (1.1-47), p < 0.05). Nine of 16 patients with early restriction also had restriction at follow up, while 15 of 16 patients without restrictive RV physiology continued without restriction. Early restriction was the only independent variable predictive of late restriction (odds ratio 6.0 (1.9-273), p = 0.01). CONCLUSIONS: Early and mid-term restrictive RV physiology after repair of tetralogy of Fallot is related to the repair type. Although evidence for this physiology tends to resolve in the first few days after operation, it is highly predictive of subsequent abnormalities of RV diastolic function. Similarly, normal RV diastolic physiology without restriction in the immediate postoperative period persists in the mid-term and may be associated with the long term problems of progressive RV dilatation. SN - 1355-6037 UR - https://www.unboundmedicine.com/medline/citation/9659195/Does_restrictive_right_ventricular_physiology_in_the_early_postoperative_period_predict_subsequent_right_ventricular_restriction_after_repair_of_tetralogy_of_Fallot L2 - http://heart.bmj.com/cgi/pmidlookup?view=long&amp;pmid=9659195 DB - PRIME DP - Unbound Medicine ER -