Mid-term prognosis of the patients after total surgical correction of tetralogy of Fallot

The aim of the study was to evaluate clinical status, exercise capacity, arrhythmia incidence, global ventricular functions and the effect of pulmonary regurgitation (PR) on ventricular functions with echocardiography.Material and Method: The myocardial performance index (MPI) determined by pulsed wave tissue Doppler imaging with the classical echocardiographic study was used for assessing global ventricular function.Results: We examined 57 patients (7,9+4,4 years) with the patients after repair of tetralogy of Fallot (TOF) and 58 healthy children. The mean duration of follow-up period was 5+3,3 years after corrective surgery. All the patients were in NYHA class I. Holter recordings were normal in all patients. In the patients group; the right ventricular (RV) EF was lower, end-diastolic and end-systolic volumes, end-diastolic areas were greater, isovolumic contraction (IVCT) and isovolumic relaxation times (IVRT) were longer and MPI were greater than those in normal children. The left ventricular (LV) EF was lower, both IVRT and IVCT were longer and MPI was greater in the patients group. Two patients (3 %) had grade 1 PR, 25 (44 %) grade 2, 29 (51 %) grade 3 and one patient (2 %) had grade 4 PR. 33 % of patients had restrictive right ventricular physiology. Total exercise time was shorter and heart rate was lower in the first steps of exercise test. There was a positive correlation between follow-up period and RV MPI. The patients with grade 3 PR had greater RV MPI and LV MPI then the patients with grade 2 PR. There were positive correlation between RV MPI and LV MPI, negative correlation between exercise times and LV MPI.Conclusion: the patients after total surgical correction of TOF had good clinical status at mid-term follow-up period but, we showed that, the exercise capacity was decreased and global functions of the both ventricles were impaired related to the degree of PR.