Dissertation
Dissertation > Medicine, health > Pediatrics > Pediatric surgery > Surgery in children of all physiological systems

The Indexes Reflecting Development of Pulmonary Artery of Patients with Tetralogy of Fallot Measured by Echocardiography: Relationship to Low Cardiac Output Syndrome after Corrective Operation

Author PengXueHui
Tutor JiangGuoPing
School Zhejiang University
Course Pediatrics
Keywords Echocardiography Doppler Spectrum Tetralogy of Fallot Pulmonary Artery Stenosis
CLC R726.5
Type Master's thesis
Year 2009
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Objective:Low cardiac output after surgery of children with Tetrology of Fallot(TOF) has close relationship with the degree of stenosis of pulmonary artery.Researchers have presented McGoon Ratio and Nakata Index to evaluate the degree of pulmonary stenosis. One purpose of this study was investigate on the relationship of McGoon ratio,Nakata index,measured by echocardiography,and low cardiac output syndrome(LCOS) occurred in chidren with Tetralogy of Fallot after surgery and compare the outcome after operation,low heart output especially,with the degree of pulmonary stenosis evaluated by McGoon ratio and Nakata index measured by echocardiography.The other purpose was to evaluate the degree of pulmonary stenosis by McGoon index and Nakata index measured by echocardiography,MVFI evaluating the degree of pulmonary stenosis,we have analyzed the correlation between mitral valve flow index (MVFI) and McGoon ratio,Nakata index.In order to discuss new cutoff to select patients operated corrective surgery,we have analyzed the relationship of MVFI, McGoon ratio,Nakata index and low cardiac output after surgery.Methods:One hundred and thirty-two patients with TOF were included into this study.All the patients had no atrial septum defects diameters of major pulmonary artery(MPA), left pulmonary artery(LPA) and right pulmonary artery(RPA) were measured at parasternal short axis view.The diameter of descending aorta at the level of septum transversum was measured at subxyphoid view.Velocity Time Integrate(VIT) of spectrum of transmitral flow and diameter of mitral annulus were measured at apical four-chamber view to calculate MVFI.The patients were followed up to confirm whether low cardiac output syndrome(LCOS) occurred after operation.McGoon ratio, Nakata index and MVFI were calculated in order to investigate their relationship with LCOS.Results:The McGoon ratio in the patients with LCOS was 0.96±0.17,and 1.78±0.31 in those without LCOS(t = 6.41,P<0.01);the Nakata index in patients with LCOS was 95.25±24.02 mm~2/m~2,and 180±39.45 mm~2/m~2 in those without LCOS(t = 5.18, P<0.01);the MVFI in patients with LCOS was 1.11±0.22 l/min/.m~2,and 2.09±0.42 l/min/m~2 in those without LCOS(t=5.60,P<0.01).Significant correlations were found between McGoon index and MVFI(R=0.78,p<0.01),and between Nakata index and MVFI(R=0.82,p<0.01).Conclusions:1.The results suggest that McGoon index>1.1,Nakata index>136 and MVFI>1.3 may be used as a cut-off value for selecting patients with TOF suitable for corrective operation.2.Significant correlations were found between McGoon index,Nakata index and MVFI by echocardiography in TOF patients without ASD and MAPCAs,which indicating MVFI can reflect the degree of pulmonary stenosis.

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