Ocena układu sercowo-naczyniowego u dzieci po korekcji tetralogii Fallota

Abstract

The aim of the study was to assess residual sequels in children after tetralogy of Fallot surgical repair (rTOF). Patients and MethodsThe study group (SG) consisted of 52 patients, mean age 13.7±3.4 years, and the control group (CG) comprised 34 healthy volunteers, mean age 13.7±3.0 years. Durations of QRS complexes and arrhythmia were assessed in ECG, Holter ECG and treadmill test. Right ventricular size was analysed by two-dimensional echocardiography. ResultsVentricular arrhythmia (VE) was detected in 18 (34%) patients. The QRS duration was longer in rTOF in whom VE was seen (151±14ms) than in those in whom no VE was found (123±19ms), p<0.05. Right ventricular dimensions were higher in SG than in CG respectively, with proximal transverse diameter: 38.8±7.9mm vs. 34.1±5,6mm (p<0.05), outflow tract in parasternal long axis view: 26.4±8.6mm vs. 18.9±7.3mm (p<0.05) and outflow tract in parasternal short axis view: 30.0±7.7mm vs. 25.4±5.1. The outflow tract diameter indexed up to body surface was statistically significantly wider (p<0.05) in patients with VE than in patients without VE 23.8±6.3mm/m2vs. 14.5±4.3mm/m2. ConclusionsThe results of tetralogy of Fallot surgical repair are good; however, after cardiosurgery some residual sequels are universally observed indicating the need of regular follow-up in this group of patients. Pulmonary valve regurgitation resulting from tetralogy of Fallot correction drives towards gradual right ventricular enlargement. Various types of arrhythmia may be observed in patients after the tetralogy of Fallot surgical repair; therefore, diagnostic procedures during follow-up should be focused on arrhythmic events detection.