RELATION BETWEEN AGE AT SURGERY AND REGRESSION OF RIGHT-VENTRICULAR HYPERTROPHY IN TETRALOGY OF FALLOT

Pre- and postoperative echocardiographic right ventricular wall thickn ess (RVW), transverse dimension (RVD), and their ratio (W/D) were meas ured from subcostal views in 29 patients with Tetralogy of Fallot (TOF ) in order to assess whether primary reparative surgery without prior palliative shunts in early infancy results in significantly faster reg ression of RV hypertrophy than repair later in life. Fourteen patients who were repaired before 6 months of age were compared with 15 patien ts who were repaired after 6 months of age. In the group of patients w ho were repaired before 6 months of age both RVW and W/D ratio decreas ed significantly whereas RVD did not change from pre- to postoperative status. The group of patients who were repaired after 6 months of age showed no significant changes in RVW, RVD, or W/D ratio. These findin gs suggest that early primary reparative surgery of TOF may have a pos itive effect on faster regression of RVH during the first postoperativ e year which may reduce the detrimental effect of longstanding hypertr ophy on myocardial function and the potential for arrhythmia.