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Early age at repair prevents restrictive right ventricular (RV) physiology after surgery for tetralogy of Fallot (TOF): diastolic RV function after TOF repair in infancy.
J Am Coll Cardiol. 1998 Oct; 32(4):1083-7.JACC

Abstract

OBJECTIVES

To assess diastolic right ventricular (RV) physiology after tetralogy of Fallot repair in infancy.

BACKGROUND

Restrictive RV physiology after tetralogy of Fallot repair is related to type of repair, pulmonary regurgitation, and late arrhythmias.

METHODS

Forty-seven patients were investigated, 27 and 20 patients in Lund and London, respectively. Median age at repair was 0.78 years (0.08-0.99) and median follow-up was 3.0 years (0.08-10.4). Restrictive RV physiology was assessed by Doppler echocardiography.

RESULTS

Thirteen patients (28%) had restrictive RV physiology at follow-up, three of 19 patients (16%) with transatrial repair and 10 of 28 patients (32%) with transventricular repair, respectively (p=0.1). Ten percent of the patients repaired before 6 months of age were restrictive at follow-up, increasing to 38% with repair after 9 months. Transannular patch (TAP) repair was performed in 55% of the patients, including eight of 10 patients (80%) with repair before 6 months of age. Thirty-one percent of the patients with TAP repair were restrictive. These restrictive patients had more severe preoperative pulmonary stenosis (p < 0.05), were older at repair (p < 0.05), and had shorter duration of pulmonary regurgitation (p < 0.001) at follow-up.

CONCLUSIONS

Restrictive RV physiology is inversely related to age at repair and independent of type of outflow tract repair. Since TAP repair is more common in early repair, and restriction seems to be less frequent, long-term follow-up to assess adverse effects of pulmonary regurgitation is mandatory.

Authors+Show Affiliations

Department of Pediatric Cardiology, University Hospital of Lund, Sweden.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

9768736

Citation

Munkhammar, P, et al. "Early Age at Repair Prevents Restrictive Right Ventricular (RV) Physiology After Surgery for Tetralogy of Fallot (TOF): Diastolic RV Function After TOF Repair in Infancy." Journal of the American College of Cardiology, vol. 32, no. 4, 1998, pp. 1083-7.
Munkhammar P, Cullen S, Jögi P, et al. Early age at repair prevents restrictive right ventricular (RV) physiology after surgery for tetralogy of Fallot (TOF): diastolic RV function after TOF repair in infancy. J Am Coll Cardiol. 1998;32(4):1083-7.
Munkhammar, P., Cullen, S., Jögi, P., de Leval, M., Elliott, M., & Norgård, G. (1998). Early age at repair prevents restrictive right ventricular (RV) physiology after surgery for tetralogy of Fallot (TOF): diastolic RV function after TOF repair in infancy. Journal of the American College of Cardiology, 32(4), 1083-7.
Munkhammar P, et al. Early Age at Repair Prevents Restrictive Right Ventricular (RV) Physiology After Surgery for Tetralogy of Fallot (TOF): Diastolic RV Function After TOF Repair in Infancy. J Am Coll Cardiol. 1998;32(4):1083-7. PubMed PMID: 9768736.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Early age at repair prevents restrictive right ventricular (RV) physiology after surgery for tetralogy of Fallot (TOF): diastolic RV function after TOF repair in infancy. AU - Munkhammar,P, AU - Cullen,S, AU - Jögi,P, AU - de Leval,M, AU - Elliott,M, AU - Norgård,G, PY - 1998/10/13/pubmed PY - 1998/10/13/medline PY - 1998/10/13/entrez SP - 1083 EP - 7 JF - Journal of the American College of Cardiology JO - J. Am. Coll. Cardiol. VL - 32 IS - 4 N2 - OBJECTIVES: To assess diastolic right ventricular (RV) physiology after tetralogy of Fallot repair in infancy. BACKGROUND: Restrictive RV physiology after tetralogy of Fallot repair is related to type of repair, pulmonary regurgitation, and late arrhythmias. METHODS: Forty-seven patients were investigated, 27 and 20 patients in Lund and London, respectively. Median age at repair was 0.78 years (0.08-0.99) and median follow-up was 3.0 years (0.08-10.4). Restrictive RV physiology was assessed by Doppler echocardiography. RESULTS: Thirteen patients (28%) had restrictive RV physiology at follow-up, three of 19 patients (16%) with transatrial repair and 10 of 28 patients (32%) with transventricular repair, respectively (p=0.1). Ten percent of the patients repaired before 6 months of age were restrictive at follow-up, increasing to 38% with repair after 9 months. Transannular patch (TAP) repair was performed in 55% of the patients, including eight of 10 patients (80%) with repair before 6 months of age. Thirty-one percent of the patients with TAP repair were restrictive. These restrictive patients had more severe preoperative pulmonary stenosis (p < 0.05), were older at repair (p < 0.05), and had shorter duration of pulmonary regurgitation (p < 0.001) at follow-up. CONCLUSIONS: Restrictive RV physiology is inversely related to age at repair and independent of type of outflow tract repair. Since TAP repair is more common in early repair, and restriction seems to be less frequent, long-term follow-up to assess adverse effects of pulmonary regurgitation is mandatory. SN - 0735-1097 UR - https://www.unboundmedicine.com/medline/citation/9768736/Early_age_at_repair_prevents_restrictive_right_ventricular__RV__physiology_after_surgery_for_tetralogy_of_Fallot__TOF_:_diastolic_RV_function_after_TOF_repair_in_infancy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735-1097(98)00351-9 DB - PRIME DP - Unbound Medicine ER -