CHARACTERIZATION OF RIGHT-VENTRICULAR DIASTOLIC PERFORMANCE AFTER COMPLETE REPAIR OF TETRALOGY OF FALLOT - RESTRICTIVE PHYSIOLOGY PREDICTS SLOW POSTOPERATIVE RECOVERY
CHARACTERIZATION OF RIGHT-VENTRICULAR DIASTOLIC PERFORMANCE AFTER COMPLETE REPAIR OF TETRALOGY OF FALLOT - RESTRICTIVE PHYSIOLOGY PREDICTS SLOW POSTOPERATIVE RECOVERY
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DOI：
10.1161/01.cir.91.6.1782
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发表时间：
1995-03-15
期刊：
影响因子：
37.8
通讯作者：
REDINGTON, A
中科院分区：
文献类型：
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作者：
CULLEN, S;SHORE, D;REDINGTON, A
背景：在法洛四联症完全修复术后，由于低心输出量状态导致的术后恢复时间延长。在这些患者中，双室收缩功能通常被很好地保存。舒张期功能受损，尤其是右室功能受损的原因尚未得到详细研究，因此，我们对该患者的右室舒张期功能进行了前瞻性研究。方法和结果我们利用多普勒超声心动图检测了双室收缩和舒张期功能。对35例6个月~45岁的法洛四联症根治术患者，在术后第1天对三尖瓣、上腔静脉、肺动脉和二尖瓣的血流频谱进行了检测。所有患者的双室收缩功能基本正常。35例患者中有17例(第1组)表现为孤立的限制性右室生理学改变，表现为肺动脉顺行血流与心房收缩相一致，并伴有明显的上腔静脉逆行血流。这一流量在呼气期增加，在吸气期消失或显著减少(P
Background Prolonged postoperative recovery caused by a low cardiac output state occurs in some patients after complete repair of tetralogy of Fallot. Biventricular systolic function is usually well preserved in these patients. The contribution of impaired diastolic function, particularly of the right ventricle, has not been studied in detail; therefore, we performed a prospective study of right ventricular diastolic function in this patient group.Methods and Results We studied biventricular systolic and diastolic function using Doppler echocardiographic examination. Tricuspid valve, superior vena caval, pulmonary arterial, and mitral valve Doppler spectrals were obtained during the first postoperative day in 35 patients aged 6 months to 45 years who underwent complete repair of tetralogy of Fallot. Biventricular systolic function was grossly normal in all patients. Isolated restrictive right ventricular physiology characterized by pulmonary arterial antegrade flow coincident with atrial systole and associated with prominent retrograde superior vena caval flow was seen in 17 of the 35 patients (group 1). This flow was augmented during the expiratory phase of positive pressure ventilation and abolished or greatly diminished during the inspiratory phase (P