Echocardiographic assessment of right ventricular functions in children after surgical repair of Tetralogy of Fallot

Shehata, Eslam M.A.; El Nagar, El-Sayed M.; El Dsoky Shara, Mohamed; Abu-Farag, Ibrahim M.

doi:10.4103/sjamf.sjamf_22_19

Echocardiographic assessment of right ventricular functions in children after surgical repair of Tetralogy of Fallot

Authors

Abstract

Introduction
Tetralogy of Fallot (TOF) is the most common form of cyanotic congenital heart disease. Between 3.5 and 10% of the patients with congenital heart disease have TOF, with males and females being affected equally.
Aim
The aim of this study is to assess right ventricular (RV) functions in children after surgical repair of TOF and to detect echocardiographic indices of prognostic value in these cases.
Patients and methods
This is a cross-sectional analytic study. It was conducted at Bab Elsharia Hospital of Al-Azhar University in Cairo over a period of 18 months from May 2017 till October 2018. It included 30 children who underwent surgical repair for TOF.
Results
A study was conducted on 30 children, comprising 11 male and 19 female children, and their mean age was 54.30±24.30 months. RV function assessment has been employed by MRI in eight cases, and conventional two-dimensional and Doppler echocardiography and finally tissue Doppler imaging in all cases. Postoperative echocardiography showed that the mean value of tricuspid annular plane systolic excursion was 14.78±4.53 mm, Myocardial Performance Index was 0.45±0.07, and RV end-diastolic diameter/left ventricular end-diastolic diameter was 1.03±0.27.
Conclusions
After surgical repair of TOF, the RV systolic and diastolic dysfunction can be detected in most patients by echocardiography in the form of prolonged Myocardial Performance Index, low value of tricuspid annular plane systolic excursion, and decreased myocardial velocities of RV. There is a significant relation between the use of transannular patch and RV dysfunction after complete surgical repair of TOF.

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