This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Alderson, P. O. Articles by Hartman, A. F. Search for Related Content PubMed PubMed Citation Articles by Alderson, P. O. Articles by Hartman, A. F., Jr

Circulation, Vol 53, 332-337, Copyright © 1976 by American Heart Association

ARTICLES

Pulmonary perfusion abnormalities and ventilation-perfusion imbalance in children after total repair of tetralogy of Fallot

PO Alderson, S Boonvisut, RC McKnight and AF Hartman Jr

The pulmonary perfusion of 25 children who had total surgical correction of tetralogy of Fallot was evaluated by radionuclide perfusion scans. In addition, 18 had 133Xe ventilation studies. Eighteen of the children previously had palliative systemic-pulmonary shunts; 14 had aortic-pulmonary shunts (Waterston or Potts-Smith) and four had Blalock-Taussig shunts. Seven children had single stage total corrections. An asymmetric perfusion pattern was found in 13 of 18 children who previously had systemic-pulmonary shunts, including 12 of 14 with previous aortic-pulmonary shunts (P less than 0.05). The most common finding was relative hypoperfusion of the lung which had received the palliative shunt (P less than 0.001). The distribution of ventilation remained relatively symmetric, even when perfusion was markedly abnormal, and this resulted in ventilation-perfusion imbalance in several patients. Asymmetric perfusion was significantly less common in patients who had undergone single stage corrections (P less than 0.05). The findings document the frequent occurrence of residual abnormalities of pulmonary perfusion and ventilation-perfusion imbalance in patients who have palliative aortic-pulmonary shunts prior to total repair, and support the position that single stage correction is preferable to aortic-pulmonary shunting in the surgical management of tetralogy of Fallot.

This article has been cited by other articles:

				U. K. Chowdhury, P. K. Mishra, R. Sharma, B. Airan, G. K. Subramaniam, S. S. Kothari, A. Bhan, C. D. Patel, and P. Venugopal Postoperative assessment of the univentricular repair by dynamic radionuclide studies Ann. Thorac. Surg., August 1, 2004; 78(2): 658 - 665. [Abstract] [Full Text] [PDF]

				I-S. Kang, A. N. Redington, L. N. Benson, C. Macgowan, E. R. Valsangiacomo, K. Roman, C. J. Kellenberger, and S.-J. Yoo Differential Regurgitation in Branch Pulmonary Arteries After Repair of Tetralogy of Fallot: A Phase-Contrast Cine Magnetic Resonance Study Circulation, June 17, 2003; 107(23): 2938 - 2943. [Abstract] [Full Text] [PDF]

				Y. Okuda, K. Takeda, T. Tagami, K. Matsumura, M. Ooi, and T. Nakagawa Effect of Embolization of Major Aortopulmonary Collateral Arteries on Cardiopulmonary Circulation in Congenital Heart Disease: Assessment with Lung Perfusion Scan Vascular and Endovascular Surgery, May 1, 1995; 29(3): 199 - 207. [Abstract] [PDF]

				H. Jonsson, T. Ivert, R. Jonasson, H. Wahlgren, A. Holmgren, and V. O. Bjork Pulmonary function thirteen to twenty-six years after repair of tetralogy of Fallot J. Thorac. Cardiovasc. Surg., December 1, 1994; 108(6): 1002 - 1009. [Abstract] [Full Text]