All issues > Volume 37(4); 1994

Original Article

J Korean Pediatr Soc. 1994;37(4):502-509. Published online April 15, 1994.

Echocardiographic Evaluation of the Changes of the Interventricular Septal Morphology in Postoperative Tetralogy of Fallot Patients

Im Jae IJ Park¹, Jun Hee JH Sul¹, Jong-Kyun JK Lee¹, Seok Min SM Choi¹, Jo Won JW Chung¹, Sung Kyu SK Lee¹, Bum Koo BK Cho²

¹Division of Pediatric Cardiology, Cardiovascular Center, Yonsei University, Seoul, Korea
²Division of Pediatric Cardiovascular, Cardiovascular Center, Yonsei University, Seoul, Korea

Abstract

The hemodynamic feature of the tetralogy of Fallot (TOF) is best characterized by equality of left and right ventricular peak systolic pressure. The interventricular septum is flattened and thickened. Even after the right ventricular pressure is normalized in the postoperative period, the morphological abnormality continues for some time. We have analyzed the morphological changes of the IVS echocardiographically after total correction and tried to correlate them with the prognosis of the patients. Forty five patients underwent total correction of TOF between May 1991 and July 1992. The IVS morphology was assessed with 2-D echocardiography before after surgery. The control group consisted of 15 normal subjects (8 with functional cardiac murmur and 7 with non-cardiac diseases). We also evaluated the influence of the residual pulmonary regurgitation (PR) or pulmonic stenosis (PS) upon sequential changes in the end-systolic configuration and the thickness of the IVS. The following results were obtained. 1) Four months after total correction the IVS thickness and configuration at end-systole of the study patients were normalized, and they were not significantly different compared to those of the control group. 2) The postoperative residual PR of mild to moderate degree did not influence the course of morphological normalization. On the other hand, the postoperative residual PS of greater than moderate degree hindered the normalization process. And the morphological abnormalities in the patients with the residual PS lasted longer than in the patients with the residual PR. 3) It would be necessary to perform cardiac catheterization in order to evaluate and to take care of the residual hemodynamic abnormalities if the IVS morphology remains to abnormal even after one year after total correction.

Keywords :Tetralogy of Fallot, Interventricular septal morphology, Echocardiography