TETRALOGY OF FALLOT REPAIR RESULTS IN ACTIVATION OF THE RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM

Fluid retention is a common problem following transannular patch repai r of tetralogy of Fallot. The present study was undertaken to evaluate whether humoral substances may contribute to this process. Patients u ndergoing tetralogy of Fallot repair using a transannular patch techni que were compared to patients undergoing simple ventricular septal def ect repair. Hormone levels were determined by radioimmunoassay. Fluid retention was defined as pleural effusions persisting beyond 5 days. T he data demonstrate that patients undergoing tetralogy of Fallot repai r had elevated levels of anti-diuretic hormone, renin, angiotensin II, and aldosterone as compared to a group with ventricular septal defect . The elevation in hormone levels in the tetralogy of Fallot group was principally accounted for jy those who developed effusions postoperat ively. These results suggest that activation of the renin-angiotensin- aldosterone system may be one of the contributing factors to fluid ret ention following tetralogy of Fallot repair.