Grudnaia i serdechno-sosudistaia khirurgiia · 1991
[Evaluation of late results of radical correction of tetralogy of Fallot based on treadmill test].
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Kudriashev V E, Beletskiĭ Iu V, Ivanov A S, Cherepenin L P, Nazarova T A, Dobrovol'skaia T N
Аннотация
The treadmill test was conducted, according to an elaborated program for evaluating insufficient pumping function of the left/right heart and the threshold of +lactic acidosis decompensation, in 53 patients before and in 86 patients after radical correction of Fallot's tetralogy. Insufficiency of left-heart pumping functions occurred after the operation significantly less frequently in patients with a monocuspic graft (14 +/- 7%; M +/- m) and more frequently in suture plastics (54 +/- 14%). A similar tendency was also authentic for right-ventricular ejection and decompensation of acidosis load. It was proved that patients with a monocusp are distinguished by higher and most stable results for a period of 5 years after the correction. Lower results were characteristic of transannular plastics and of patients who were operated on through a longitudinal approach; the lowest results occurred in suture plastics through a transverse approach. It was found that ++re-shunting of the ventricular septal defect levels the results of the various types of correction of the anomaly. It is shown that the criteria of insufficiency of the heart pumping function may be used in the diagnosis of latent stenoses and regurgitations of the infundibulum of the heart and the pulmonary artery whose functional significance is revealed only during a load.