Experience share of tetralogy on 38 cases with stage Ⅰ Fallot children and little left ventricle / 中国综合临床

ABSTRACT

Objective To share the clinical experience of tetralogy of stage Ⅰ Fallot children with little left ventricle.Methods Thirty-eight cases with stage Ⅰ Fallot with little left ventricle from March 2008 to Jun 2012 were selected as our subjects.Of them,18 were boys and 20 were girls.The age of the cases ranged from 5 to 18 months and average was (9.37 ±2.45) months.The weight ranged from 6.6 to 10.4 kg,and average was (8.33 ± 1.72) kg.All cases showed cyanosis of oral lip.They all were performed tetralogy by the breast bone median incision and then expanding interventricular septal defect.Results All cases survived.Following-up 6 -18 months showed that all cases got good recovery.Left arterial diameter at before the operation,discharge,3 months after surgery were (14.07 ± 0.79) mm,(14.37 ± 0.68) mm,(16.01 ± 0.72) mm respectively and transverse diameter of right atrium were (18.23 ± 1.07) mm,(18.74 ± 0.96) mm,(19.28 ± 0.71) mm respectively.The differences were significant (F =99.474,69.760,P =0.000).Main pulmonary artery diameter at before the operation,discharge,3 months after surgery were (7.98 ±0.92) mm,(8.16 ±0.54) mm and (9.92 ± 0.81) mm,and left ventricular end diastolic diameter were (19.27 ± 1.15) mm,(21.06 ± 1.75) mm,(23.41 ± 1.18) mm.Meanwhile,left ventricular fractional shortening rate were (35.57 ± 1.45)％,(32.61 ± 2.15) ％,(34.29 ± 2.12) ％,and main pulmonary artery systolic flow velocity were (450 ± 98.36) cm/s,(150.0 ± 9.22) cm/s,(148.0 ± 7.92) cm/s.All differences were statistically significant (F =108.620,96.410,99.485,102.914;P =0.000).Conclusion Tetralogy on Fallot children with little left ventricle can lead to cardiac remodeling,which reduce the load of right ventricle and improve left ventricular function.