Congenital heart diseaseImpact of Right Ventricular Volume Overload on Three-Dimensional Global Left Ventricular Mechanical Dyssynchrony After Surgical Repair of Tetralogy of Fallot
Section snippets
Methods
Sixty patients (34 men), aged 18.9 ± 7.9 years, who have undergone surgical repair of TOF were recruited prospectively from the pediatric cardiac clinic. Of the 60 patients, 5 had TOF with pulmonary atresia. Twenty-nine (13 males) healthy subjects, aged 16.6 ± 6.4 years (p = 0.17), followed up in the cardiac clinic for nonspecific chest pain and palpitation but without documented cardiac arrhythmias; healthy siblings of patients were recruited as controls. The following data were retrieved from
Results
Of the 60 patients, 21 had initial systemic-to-pulmonary arterial shunt palliation. Total correction was performed at 4.5 ± 3.6 years of age with transannular patch enlargement of the RV outflow in 40 patients, without a transannular patch in 10, with a valved conduit insertion in 7, and a nonvalved conduit in 3. All of the patients were asymptomatic at the time of study. The QRS duration of the patients was 143 ± 26 ms. Compared with controls, patients had similar weight (45.2 ± 15.2 kg vs
Discussion
The present study demonstrates that 3-dimensional global LV systolic mechanical dyssynchrony is highly prevalent after surgical repair of TOF. Using 2-dimensional tissue Doppler analysis, El Rahman et al7 has demonstrated delay of septal deformation in 52% of TOF patients studied at a median age of 19 years. Although their findings suggest LV mechanical dyssynchrony, significant overlap in LV deformation delay was noted between their patients and controls. However, we were able to show
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