No CrossRef data available.
Article contents
Total correction of tetralogy of Fallot without “routine”preoperative cardiac catheterization—management of 99 patients
Published online by Cambridge University Press: 19 August 2008
Summary
Between January 1989 and March 1993, total correction was performed in 99 patients with tetralogy of Fallot without submitting them to prior cardiac catheterization. The age of the patients ranged from 1.33 to 18 years (mean 5.33±3.77). After complete echocardiographic examination, the diameters of the right and left pulmonary arteries at the prebranching point and the descending thoracic aorta at the diaphragm were measured by cross-sectional echocardiography and the McGoon ratio was calculated. Total correction was performed in all patients with a McGoon ratio greater than 1.7. In none of the patients were the sizes of the pulmonary artery measured by echocardiography smaller than the measurements obtained during surgery. Transannular patching was performed in 76 patients. A conduit from the right ventricle to the pulmonary arteries was constructed in two patients with coronary arterial anomalies. Postrepair right ventricular to left ventricular systolic pressure ratios were between 0.25 and 0.85 (mean 0.54±0.13). There were two hospital deaths, neither being related to the diagnostic method used nor the criteria for surgery. We conclude that the diagnosis of tetralogy of Fallot together with measurements of pulmonary arteries and descending thoracic aorta can safely and reliably be achieved echocardiographically. The McGoon ratio can be adapted to echocardiography and total correction can be performed successfully based on echocardiographic examination.
- Type
- Original Articles
- Information
- Copyright
- Copyright © Cambridge University Press 1994
References
Kirklin, JW, Blackstone, EH, Pacifico, AD, Bargeron, LM.Risk factors for early and late failure after repair of tetralogy of Fallot, and their neutralization. Thorac Cardiovasc Surgeon 1984; 32: 208–214.CrossRefGoogle ScholarPubMed
McGoon, DC, Baird, DK, Davis, GD.Surgical management of large bronchial collateral arteries with pulmonary stenosis or atresia. Circulation 1975; 52: 109–118.CrossRefGoogle ScholarPubMed
Nakata, S, Imai, Y, Takanashi, Y, Kurosawa, H, Tezuka, K, Nakazawa, M, Ando, M, Takao, A.A new method for the quantitative standard ization of cross-sectional areas of the pulmonary arteries in congenital heart disease with decreased pulmonary blood flow. J Thorac Cardiovasc Surg 1984; 88: 610–619.CrossRefGoogle Scholar
Hagler, DJ, Tajik, AJ, Seward, JB, Mair, DD, Ritter, DG.Wide-angle two dimensional echocardiographicprofilesofconotruncal abnormalities. Mayo Clin Proc 1980; 55: 73–82.Google ScholarPubMed
Huhta, JC, Piehler, JM, Tajik, AJ, Hagler, DJ, Mair, DD, Julsrud, PR, Seward, JSB.Two dimensional echocardiographic detection and measurement of the right pulmonary artery in pulmonary atresia-ventricular septal defect: Angiographic and surgical correlation. Am J Cardiol 1982; 49: 1235–1240.CrossRefGoogle ScholarPubMed
Lappen, RS, Riggs, TW, Lapin, GD, Paul, MH, Muster, AJ.Two dimensional echocardiographic measurement of right pulmonary artery diameter in infants and children. J Am Coll Cardiol 1983; 2: 121–126.CrossRefGoogle ScholarPubMed
Tajik, AJ, Seward, JB, Hagler, DJ, Mair, DD, Lie, JT.Two-dimensional real time ultrasonic imaging of the heart and great vessels. Technique, image orientation, structure identification, and validation. Mayo Clin Proc 1978; 53: 271–303.Google ScholarPubMed
Silverman, NH, Snider, AR, Colo, J. A segmental approach to the diagnosis of congenital heart disease: the usefulness of two- dimensional echocardiography. In: Hunters, Hall R(eds). Echocardiography. Churchill Livingstone, Edinburg, London, Melbourne and New York, 1982, pp 165–192.Google Scholar
Berry, JM, Einzig, S, Krabill, KA, Bass, JL.Evaluation of coronary artery anatomy in patients with tetralogy of Fallot by two- dimensional echocardiography. Circulation 1988; 78: 149–156.CrossRefGoogle ScholarPubMed
Jureidini, SB, Appleton, RS, Nouri, S, Crawford, CJ.Detection of coronary artery abnormalities in tetralogy of Fallot by two- dimensional echocardiography. J Am CoIl Cardiol 1989; 14: 960–967.CrossRefGoogle ScholarPubMed
Rice, MS, Seward, JB, Hagler, DJ, Mair, DD, Felt, RH, Puga, FS, Danielson, GK, Edwards, WD, Tajik, AJ. Impact of 2-dimensional echocardiography on the management of distressed new borns in whom cardiac disease is suspected. J Am Cardiol 1983; 51: 288–292.CrossRefGoogle Scholar
Stark, J, Smallhorn, J, Huhta, J, Leval, M, Macartney, FJ, Rees, FG, Taylor, JFN.Surgery for congenital heart defects diagnosed with cross sectional echocardiography. Circulation 1983; 68(Suppl IIyes): ll 129– ll 138.Google ScholarPubMed
Marino, B, Corno, A, Pasquini, L, Guccione, P, Carta, MG, Ballerini, L, de Simone, G, Marcelletti, C. Indication for systemic- pulmonary artery shunts guided by two-dimensional and Doppler echocardiography: Criteria for patient selection. Ann Thorac Surg 1987; 44: 495–498.CrossRefGoogle ScholarPubMed
Ueda, K, Nojima, K, Saito, A, Nakano, H, Yokota, M, Muraoka, R.Modified Blalock-Taussig shunt operation without cardiac catheterization: Two dimensional echocardiogmphic preopetative assessment in cyanotic inflints. Am J Cardiol 1984; 54: 1296–1299.CrossRefGoogle Scholar
Sreeram, N, Colli, AM, Monro, JL, Shore, DF, Lamb, RK, Fong, LV, Smyllie, JH, Keeton, BR, Sutherland, GR.Changing role of non-invasive investigation in the preoperative assessment of congenital heartdisease: a nine year experience. Br Heart J 1990; 63: 345–349.CrossRefGoogle Scholar
Shimazaki, Y, Blackstone, EH, Kirklin, JW, Jonas, A, Mandell, V, Colvin, EV.The dimensions of the right ventricular outflow tract and pulmonary arteries in tetralogy of Fallot and pulmonary stenosis. J Thorac Cardiovasc Surg 1992; 103: 692–705.CrossRefGoogle ScholarPubMed
Fellows, KE, Smith, J, Keane, JF.Preoperative angiography in infants with tetralogy of Fallot. Am J Cardiol 1981; 47: 1279–1285.CrossRefGoogle Scholar
Humes, RA, Driscoll, DJ, Danielson, GK, Puga, FJ.Tetralogyof Fallot with anomalous origin of left anterior descending coronary artery, surgical options. J Thorac Cardiovasc Surg 1987; 94: 784–787.CrossRefGoogle ScholarPubMed
Kirklin, JW, Barratt-Boyes, BG.Cardiac Surgery. Churchill Livingstone, New York, 1993, pp 861–1013.Google ScholarPubMed
Blackstone, EH, Kirklin, JW, Bertranou, E, Labrosse, CJ, Soto, B, Bargeron, LM.Preoperative prediction from cineangiogram of postrepair right ventricular pressure in tetralogy of Fallot. J Thorac Cardiovasc Surg 1979; 78: 542–552.CrossRefGoogle ScholarPubMed
Aytaç, A, Sarioglu, T, Olga, R, Akçevin, A, Yurdakul, Y, Ikizler, C, Ertugrul, A, Bayindir, O, Polat, AB. 25 years experience in total repair in tetralogy of Fallot. Crupi, C, Anderson, RH, Parenzan, L (eds). Pediatric Cardiac Surgery. Part I. Futura Publishing Company, Mount Kisco, NY, 1989.Google Scholar