THE INFLUENCE OF PULMONARY-INSUFFICIENCY ON VENTRICULAR-FUNCTION FOLLOWING TOTAL CORRECTION OF FALLOT TETRALOGY - EVALUATION USING RADIONUCLIDE VENTRICULOGRAPHY AND CLINICAL FINDINGS

Long-standing pulmonary insufficiency after repair of tetralogy of Fal lot may adversely affect ventricular function. We evaluated 20 patient s postoperatively by radionuclide ventriculography and clinical findin gs after total correction of tetralogy of Fallot. Patients were divide d into two groups as follows: Group I patients (10) had no pulmonary i nsufficiency; Group II patients (10) had moderate or severe pulmonary insufficiency. Preoperatively, there was no difference between groups in terms of age, functional capacity according to the New York Heart A ssociation criteria, hemoglobin and hematocrit level, cardiothoracic r atio, McGoon ratio, left and right ventricular ejection fraction, card iac output or cardiac index. Postoperatively, right ventricular ejecti on fraction was 40.10 +/- 2.28 in Group I and 29.5 +/- 2.86 in Group I I, p < 0.01. Left ventricular ejection fraction was 59.3 +/- 2.90 in G roup I and 50.9 +/- 4.19 in Group II, p < 0.01. Radionuclide ventricul ography is a useful means of identifying right ventricular dysfunction following repair of tetralogy of Fallot. The dysfunction appears sign ificantly worse in patients with pulmonary insufficiency.