Hemodynamic and functioanl evaluation of the right ventricle after radical correction of Fallot's tetrad

A.Yu. Omelchenko, Yu.N. Gorbatykh, I.A. Soinov, A.V. Voitov, Yu.Yu. Kulyabin, I.A. Kornilov, S.M. Ivantsov, A.V. Bogachev-Prokofiev
Keywords: tetralogy of Fallot, pulmonaty insufficiency, right ventricle dysfunction
Medicinskij al'manah, 2016, issue 4, pages 93-99.

A prospective cohort study includes 54 patients underwent primary repair of tetralogy of Fallot. Patients
were divided in 2 groups by the type of outflow tract reconstruction: first group consists of patients
with transannular plasty (I group, 26 pts), the second group includes patients with preserved pulmonary
annulus (II group, 26 pts). Assess hemodynamic parameters in early postoperative period in patients
underwent primary repair of tetralogy of Fallot depending on different types of right ventricular outflow
tract plasty and evaluate function of the right ventricle in late postoperative period. We have conclusion:
preservation of the pulmonary annulus provide better hemodynamic parameters in early postoperative
period and current patients are less predisposed to right ventricle dysfunction in late postoperative period.

1. Kadam S.V., Tailor K.B., Kulkarni S. et al. Effect of dexmeditomidine on

postoperative junctional ectopic tachycardia after complete surgical repair
of tetralogy of Fallot: A prospective randomized controlled study. Ann Card
Anaesth. 2015. Jul-Sep. № 18 (3). Р. 323-328.
2. Marterer R., Hongchun Z., Tschauner S. et al. Cardiac MRI assessment of
right ventricular function: impact of right bundle branch block on the evaluation
of cardiac performance parameters. Eur Radiol. 2015. Dec. № 25 (12).
Р. 3528-3535.
3. Omelchenko A.Y., Gorbatykh Y.N., Soynov I.A. i dr. Otsenka funktsii pravogo
zheludochka posle korrektsii tetrady Fallo. Sibirskiy nauchnyy meditsinskiy
zhurnal.. 2016. Т. 36. № 3. S. 48-54.
4. Sukhanov S.G, Orekhova E. N., Sinelnikov Y. S. i dr. Mekhanicheskaya
funktsiya pravogo zheludochka u detey pervogo goda zhizni s tetradoy
Fallo. Patologiya krovoobrashcheniya i kardiokhirurgiya. 2015. № 3. S. 19-25.
5. Fakler U., Pauli Ch., Balling G. et al. Cardiac index monitoring by pulse
contour analysis and thermodilution after pediatric cardiac surgery. J Thor
Cardiovasc Surg. 2007. Jan. № 133 (1). Р. 224-228.
6. Perevozchikova A., Strunin O., Karaskov A. et al. Dynamics of extravascular
lung water volume in infants after congenital heart surgery with cardiopulmonary
bypass. J Cardiothor Vasc Anest. 2011. Jun. № 25. Р. 10.
7. Bove T., Vandekerckhove K., Devos D. et al. Functional analysis of the
anatomical right ventricular components: should assessment of right ventricular
function after repair of tetralogy of Fallot be refined? Eur J Cardiothorac Surg.
2014. Feb. № 45. Р. 6-12.
8. Lytrivi I.D., Ko H.H., Srivastava S. et al. Regional differences in right
ventricular systolic function as determined by cine magnetic resonance imaging
after infundibulotomy. Am J Cardiol. 2004. № 94. Р. 970-973.
9. Johnson R.J., Haworth S.G. Pulmonary vascular and alveolar development
in tetralogy of Fallot: a recommendation for early correction. Thorax. 1982. Dec.
№ 37 (12). Р. 893-901.
10. Strunin O.V., Perevozchikova A.A., Lomivorotov V.V. i dr. Sostoyanie
osnovnykh parametrov gemodinamiki po dannym transpul'monal'noy
termodilyutsii u detey s massoy tela menee 10 kg posle korrektsii vrozhdennykh
porokov serdtsa s legochnoy gipervolemiey. Kardiologiya i serdechnososudistaya
khirurgiya. 2012. Т. 5. № 2. S. 98-103.
11. Gorter T.M., van Melle J.P., Freling H.G. et al. Pulmonary regurgitant volume
is superior to fraction using background-corrected phase contrast MRI in
determining the severity of regurgitation in repaired tetralogy of Fallot. Int J
Cardiovasc Imaging. 2015. Aug. № 31 (6). Р. 1169-1177.
12. Alghamdi M.H., Mertens L., Lee W. et al. Longitudinal right ventricular
function is a better predictor of right ventricular contribution to exercise performance
than global or outflow tract ejection fraction in tetralogy of Fallot: a
combined echocardiography and magnetic resonance study. Eur Heart J Cardiovasc
Imaging. 2013. № 14. Р. 235-239.
13. Wald R.M., Haber I., Wald R. et al. Effects of regional dysfunction and
late gadolinium enhancement on global right ventricular function and exercise
capacity in patients with repaired tetralogy of Fallot. Circulation. 2009. № 119.
Р. 1370-1377.
14. Morcos P., Vick G.W., Sahn D.J. et al. Correlation of right ventricular
ejection fraction and tricuspid annular plane systolic excursion in tetralogy of
Fallot by magnetic resonance imaging. Int J Cardiovasc Imaging. 2009. № 25.
Р. 263-270.
15. Selly J.B, Iriart X., Roubertie F. et al. Multivariable assessment of the right
ventricle by echocardiography in patients with repaired tetralogy of Fallotundergoing
pulmonary valve replacement: a comparative study with magnetic resonance
imaging. Arch Cardiovasc Dis. 2015. Jan. № 108 (1). Р. 5-15.
16. Bigdelian H., Mardani D., Sedighi M. The effect of pulmonary valve replacement
surgery on hemodynamics of patients who underwent repair of tetralogy
of Fallot. J Cardiovasc Thorac Res. 2015. № 7 (3). Р. 122-125.
17. Sabate Rotes A., Connolly H.M., Warnes C.A. et al. Ventricular arrhythmia
risk stratification in patients with tetralogy of Fallot at the time of pulmonary
valvereplacement. Circ Arrhythm Electrophysiol. 2015. Feb. № 8 (1). Р. 110-116.
18. Buechel E.R., Dave H.H., Kellenberger C.J. et al. Remodelling of the right
ventricle after early pulmonary valve replacement in children with repaired tetralogy
of Fallot: assessment by cardiovascular magnetic resonance. Eur Heart J.
2005. № 26. Р. 2721-2727.
19. Oosterhof T., van Straten A., Vliegen H.W. et al. Preoperative tresholds
for pulmonary valve replacement in patients with corrected tetralogy of Fallot
using cardiac magnetic resonance. Circulation. 2007. № 116. Р. 545-551.

A.Yu. Omelchenko, Yu.N. Gorbatykh, I.A. Soinov, A.V. Voitov, Yu.Yu. Kulyabin, I.A. Kornilov, S.M. Ivantsov, A.V. Bogachev-Prokofiev Hemodynamic and functioanl evaluation of the right ventricle after radical correction of Fallot's tetrad . Medicinskij al'manah 2016; (4): 93–99, http://dx.doi.org/10.21145/2499-9954-2016-4-93-99