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Left ventricular function in tricuspid atresia: a radionuclide study.

R A Hurwitz, R L Caldwell, D A Girod

    Journal of the American College of Cardiology
    |October 1, 1986
    PubMed
    Summary
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    Left ventricular function in tricuspid atresia patients remains below normal before and after the Fontan operation. While systolic function may not improve immediately, serial studies suggest potential for later recovery.

    Area of Science:

    • Cardiology
    • Pediatric Cardiology
    • Cardiac Surgery

    Background:

    • Tricuspid atresia requires complex surgical palliation, often involving the Fontan procedure.
    • Assessing long-term left ventricular (LV) function is crucial for outcomes in these patients.

    Purpose of the Study:

    • To evaluate changes in LV ejection fraction (LVEF) in patients with tricuspid atresia before and after the Fontan operation.
    • To identify factors influencing LV function and correlate it with clinical status.

    Main Methods:

    • Radionuclide angiocardiography (RNA) was used to assess LVEF in 29 preoperative and 14 postoperative patients.
    • Serial studies were conducted preoperatively and postoperatively in a subset of patients.
    • LV function was analyzed in relation to age, oxygen saturation, and clinical symptoms.

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    Main Results:

    • Preoperative and postoperative LVEF were significantly lower than normal institutional values (p < 0.001).
    • No significant difference was found between preoperative and postoperative group mean LVEF.
    • Postoperative systolic dysfunction was observed in some patients, but only one was symptomatic.

    Conclusions:

    • LV function in tricuspid atresia patients is variable and generally depressed, both before and after the Fontan procedure.
    • Fontan operation after 5 years of age does not guarantee LVEF improvement and may lead to a decrease.
    • Serial assessment suggests potential for early postoperative improvement in LVEF over 1-3 years.