Left Ventricular Function Following Attempted Surgical Repair of Tetralogy of Fallot

SUMMARY Left ventricular function was assessed by angio-graphic methods in 40 patients (ages 3-27), 1-12 years following repair of tetralogy of Fallot. Twenty of the 40 patients (group A) had a satisfactory repair with a pulmonary-systemic flow ratio (Qp/Qs).! 1.5 and a right ventricular systolic pressure of < 60 % of the left ventricular value. The other 20 patients (group B) had a Qp/Qs> 1.5 and/or a right ventricular systolic pressure> 60 % of the left ven-tricular value. Group A patients had a normal left ventricular end-ALTHOUGH REPAIR of tetralogy of Fallot (TOF) has become a well-established surgical procedure, ' only limited information concerning postoperative left ventricular (LV) performance is available. Following successful repair, elevated left ventricular end-diastolic volume (LVEDV) and depressed ejection fraction (LVEF) were reported by Jar-makani et al.5 using angiographic analyses. However, Sunderland et al.0 demonstrated normal LV function post-operatively, based on measurements of systemic arterial systolic pressure, cardiac index, arteriovenous oxygen difference, and LVEF, among patients who had undergone repair under two years of age, none of whom had prior palliative procedures. LaCorte et al.7 also noted a normal LVEF using echocardiographic techniques among older patients following successful surgery. It is the purpose of this communication to report our observations regarding LV function derived from angio-graphic analysis obtained at cardiac catheterization of 40 patients who had previously undergone repair ofTOF and to attempt to identify factors responsible for the LV dysfunc-tion noted in some