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Evaluation of Right Ventricular Systolic Function Pre-and Post-Operation in Patients with Tetralogy of Tetralogy of Fallot by Real Time Three Dimensional Echocardiography

Author: WuZhiYuan
Tutor: ZhaoHong
School: Hebei Medical University
Course: Surgery
Keywords: Tetralogy of Fallot Real-time three-dimensional echocardi-ography 64-slice spiral CT Tei index McGoon index
CLC: R654.2
Type: Master's thesis
Year: 2014
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Tetralogy of Fallot (TOF) is a Congenital heart disease which we oftencalled right-left shunt cyanotic heart disease. The main pathological changesinclude: ventricular septal defect, right ventricular hypertrophy, pulmonaryhypertension and aortic saddle. Echocardiography can make a correctdiagnosis of tetralogy of Fallot, so that we can arrive at a correctunderstanding of the disease. With the continuous updating of medicalimaging technology, emergence of real-time three-dimensional echocardiogra-phy providing a more accurate basis and evidence to the patients of TOF. Notonly can immediately render specific forms and structures of the heart, and theheart can be divided in different planes, the measurement of the heart fromdifferent angles, complete display heart attack position, size; adjacentrelationship and three-dimensional morphology of the lesion around. Moreintuitive showing the range of lesions, the lesion specific image in front of us.Meanwhile the state and function of the right ventricular which in patients ofTOF are closely related with the surgery and prognosis. Quality of life andsurvival of tetralogy of Fallot patients after surgery directly affected their rightventricular function. Therefore, an accurate assessment of right ventricularfunction have an very important significance for clinical,especially to thepatients of TOF. Cardiac function index which is Tei index can better reflectthe function of cardiac systolic and diastolic. Using real-time three-dimensional echocardiography to measure Tei index is convenient, fast andwill not cause trauma to the patients. Objective:1Researching the significance of real-time three-dimensional echocardi-ography to the patients of TOF.2Researching the correlation between real-time three-dimensionalechocardiography (RT-3DE) and MRI to gudie clinical treatment.3Researching the effect of different surgical methods to the Tei index.Methods: Collect the patients of TOF in our hospital form January2011-2013October.While excluding patients which with other cardiacmalformations that require surgical repair at the same time. All30patientswere underwent surgery under anesthesia and CPB. Recording the time ofsurgery,CPB,ventilator,drug application and intensive care.All the patients ofTOF were underwent MRI and real-time three-dimensional echocardiographyreach. Measuring right ventricular end-diastolic volume, end-systolic capacity,and calculate ejection fraction. Comparison the relationship between MRI andreal-time three-dimensional echocardiography. The different stages of themeasured data were analyzed. The measured data were applied as mean±standard deviation(x±s).Useing spss13.0software for statistical analysis.Results:130patients of TOF have no differents among the time of surgery, CPB,ventilator,drug application and intensive care. The time of surgery is105±23.5min;The time of CPB is79.5±19.4min;The time of drug applicationis58.2±14.7min.2There are seven cases of patients who right ventricular systolicfunction is poor before surgery, EF values less than45%, accounting for23.3%in the number of cases in all30patients collected. After surgery,using real-time three-dimensional echocardiography to measure rightventricular diameter was smaller than the average, and right ventricular EFincreased compared with preoperative values.There is a well relationshipbetween real-time three-dimensional echocardiography and MRI. Rightventricular ejection fraction EF index was linearly related.3Compared with before surgery Tei index was declined.(P<0.05). Conclusions:1Real-time three-dimensional echocardiography can assess the exactstatus of right heart function in Fallot tetralogy patients.2Tei index and right ventricular ejection fraction can indirectly reflectthe impact of the disease on the pulmonary artery.3After surgery there are huge changes on the right heart function and theTei index.4In heart changes occurred after surgery.Tei index wasdeclined.Different surgical methods have different effects on Tei index.

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CLC: > Medicine, health > Surgery > Of surgery > Cardiovascular and lymphatic system surgery > Heart
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