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Updated: Aug 1, 2026
Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
Published on: October 28, 2020
Quantitative analysis of hypertrophy in cardiac chambers in cyanotic tetralogy of Fallot
M Noma1, A Sekiguchi, M Chikada
1Division of Cardiovascular Surgery, National Children's Hospital, Tokyo, Japan.
Insights
Tetralogy of Fallot repair shows long-term complications. This study quantifies heart chamber hypertrophy in patients with cyanotic tetralogy of Fallot, revealing age-related changes and the impact of surgical interventions.
Area of Science:
- Cardiology
- Pediatric Cardiac Surgery
- Pathology
Background:
- Surgical repair of cyanotic tetralogy of Fallot is common, but long-term complications persist.
- Optimal timing and procedures for surgical intervention remain debated.
- Understanding morphological changes is crucial for managing this congenital heart defect.
Purpose of the Study:
- To quantitatively analyze cardiac chamber hypertrophy in tetralogy of Fallot.
- To evaluate the progression of cardiac lesions with age.
- To assess the influence of surgical interventions on heart morphology.
Main Methods:
- Quantitative analysis of myocardial mass index in 87 autopsied hearts with cyanotic tetralogy of Fallot.
- Comparison with 71 normal control hearts.
- Evaluation of age-related changes and effects of pulmonary atresia, palliative operations, and total corrective repair.
Main Results:
- Right ventricle and right atrium hypertrophy progresses postnatally in tetralogy of Fallot.
- The left heart is normal or atrophied, potentially correctable by intervention.
- Ventricular growth curves were parallel to normal hearts; surgical interventions impact morphology.
Conclusions:
- Early surgical repair of tetralogy of Fallot can lead to long-term complications.
- Understanding age-related hypertrophy and the effects of interventions is key.
- Morphological characteristics are influenced by pulmonary atresia and surgical strategies.
Abstract:
Although early total corrective repair for cyanotic tetralogy of Fallot is now safely performed at many institutions, long-term complications after surgical repair have been demonstrated. Therefore, the optimal procedure and timing for surgical treatment remain controxersial. In the present study, we conducted a quantitative analysis of the hypertrophy of all four chambers of 87 autopsied hearts of cyanotic tetralogy of Fallot and 71 normal control hearts utilizing the myocardial mass index, and evaluated the progression of lesions with advancing age. In cyanotic tetralogy of Fallot, hypertrophy of the right ventricle progresses immediately after birth, with that of the right atrium developing soon after. The left side of the heart is normal or slightly atrophied which could be corrected by sufficient palliative intervention or total corrective repair. The growth curves of both ventricles were parallel to those of normal hearts for the period studied. Pulmonary atresia, palliative operation, and total corrective repair have been shown to have some influence on the morphological characteristics of hearts of cyanotic tetralogy of Fallot.
