PMID: 9423089Jun 1, 1994Paper

Reoperation for tetralogy of Fallot

Rinshō Kyōbu Geka = Japanese Annals of Thoracic Surgery
K HashimotoR Nagahori

Abstract

We experienced 6 cases of reoperations after the intracardiac repair of tetralogy of Fallot between Nov. 1991 and Feb. 1994. Mild to moderate left to right shunts and pulmonary stenosis were observed in all patients. Pulmonary insufficiency was detected by echocardiography in all patients but one. All diagnosed residual problems were repaired at this time of operations. Cardiac parameters such as CTR, left and right ventricular dimensions were all improved in the association of NYHA improvement. The % changes of ventricular dimensions were influenced by the severity of shunt and pressure gradient. Perioperative pressure-volume loops demonstrated that the degree of left to right shunt correlated with the % changes of stroke work and pressure-volume area, which were considered to determine the myocardial oxygen demand. Thus the repairs reduced certainly the oxygen demand of the heart. We concluded that the residual complications could be safely handled by the reoperation and the repairs were extremely meaningful for the quality of life in patients.

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