Assessment of right ventricular diastolic function: does it predict post-operative course in tetralogy of Fallot.

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dc.contributor.authorRathore, Kaushlendra Singhen_US
dc.contributor.authorGupta, Nirmalen_US
dc.contributor.authorKapoor, Adityaen_US
dc.contributor.authorModi, Nitinen_US
dc.contributor.authorSingh, P Ken_US
dc.contributor.authorTewari, Prabhaten_US
dc.contributor.authorSinha, Nakulen_US
dc.date.accessioned2004-05-09en_US
dc.date.accessioned2009-05-27T04:20:50Z
dc.date.available2004-05-09en_US
dc.date.available2009-05-27T04:20:50Z
dc.date.issued2004-05-09en_US
dc.description.abstractBACKGROUND: In some cases of tetralogy of Fallot the post-operative course is characterized by episodes of low cardiac output, elevated central filling pressures and prolonged ventilation and inotropic support. This may be due to impaired diastolic function of the right ventricle despite preservation of biventricular systolic function. METHODS AND RESULTS: Sixty-four consecutive patients (mean age 7.06+/-4.9 years) undergoing repair of tetralogy of Fallot were prospectively studied to assess right ventricular diastolic function. 'Restrictive physiology' was defined as presence of laminar antegrade diastolic pulmonary artery flow (A wave) throughout the respiratory cycle, which was coincident with atrial systole. Right ventricle restriction was present in 45/64 (70%, Group 1) patients and absent in 19/64 (30%, Group 2) patients. There was a marked inspiratory augmentation of the pulmonary artery A wave velocity, flow integral and duration. Transtricuspid flow revealed significantly lower peak E velocity, lower E/A ratio, shorter E deceleration time and higher A velocity time integral in those with right ventricular restriction. Biventricular systolic function and transmitral flow were normal in all patients. Those with restrictive physiology had significantly longer mean inotrope support duration, longer ventilation and chest drainage times. Correspondingly, the mean intensive care unit stay (56.7+/-9.3 v. 34.7+/-5.38 hours, p<0.01) and mean hospital discharge time (9.3+/-2.3 v. 6.2+/-0.5 days, p <0.001) was also significantly longer in group 1. CONCLUSIONS: Right ventricular restriction (as seen by laminar antegrade diastolic pulmonary artery flow throughout the respiratory cycle) exists in a significant subset of patients with tetralogy of Fallot following operative repair. Following surgery, such patients have higher inotropic requirement, longer ventilation times and longer hospital stay.en_US
dc.description.affiliationDepartment of Cardiovascular and Thoracic Surgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow.en_US
dc.identifier.citationRathore KS, Gupta N, Kapoor A, Modi N, Singh PK, Tewari P, Sinha N. Assessment of right ventricular diastolic function: does it predict post-operative course in tetralogy of Fallot. Indian Heart Journal. 2004 May-Jun; 56(3): 220-4en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/3859
dc.language.isoengen_US
dc.source.urihttps://indianheartjournal.comen_US
dc.subject.meshAdolescenten_US
dc.subject.meshAdulten_US
dc.subject.meshBlood Flow Velocityen_US
dc.subject.meshChilden_US
dc.subject.meshChild, Preschoolen_US
dc.subject.meshDiastoleen_US
dc.subject.meshEchocardiography, Doppleren_US
dc.subject.meshFemaleen_US
dc.subject.meshFollow-Up Studiesen_US
dc.subject.meshHumansen_US
dc.subject.meshInfanten_US
dc.subject.meshLength of Stayen_US
dc.subject.meshMaleen_US
dc.subject.meshPostoperative Careen_US
dc.subject.meshPrognosisen_US
dc.subject.meshProspective Studiesen_US
dc.subject.meshPulmonary Artery --physiopathologyen_US
dc.subject.meshTetralogy of Fallot --physiopathologyen_US
dc.subject.meshVentricular Function, Righten_US
dc.titleAssessment of right ventricular diastolic function: does it predict post-operative course in tetralogy of Fallot.en_US
dc.typeComparative Studyen_US
dc.typeJournal Articleen_US
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