Right ventricular Hemodynamic Alteration after Pulmonary Valve Replacement in Children with Congenital Heart Disease

Introduction: in patients who underwent surgery to repair tetralogy of fallot,right ventricular dilation from pulmonary regurgitation may be result in rightventricular failure, arrhythmias, and cardiac arrest. hence, pulmonary valvereplacement may be necessary to reduce right ventricular volume overload. theaim of present study was to assess the effects of pulmonary valve replacementon right ventricular function after repair of tetralogy of fallot.materials and methods: this retrospective study was carried out between july2011 and october 2013 on 21 consecutive patients in chamran heart center(isfahan, iran). the study included 13 male (61.9%) and 8 female (38.1%).cardiac magnetic resonance was performed before, 6 and 12 months afterpulmonary valve replacement in all patients (babak imaging center, tehran)with the 1.5 tesla system. the main reason for surgery at tetralogy of fallotrepaired time was tetralogy of fallot + pulmonary insufficiency (17 cases) andtetralogy of fallot + pulmonary atresia (4 cases). right ventricular function wasassessed before and after pulmonary valve replacement with two-dimensionalechocardiography and t-test was used to evaluate follow-up data.results: right ventricular end-diastolic volume and right ventricular endsystolicvolume were significantly decreased (p value?0.05). right ventricularejection fraction had a significant increase (p value?0.05). right ventricularmass substantially shrank after pulmonary valve replacement. moreover,pulmonary regurgitation noticeably decreased in patients. the otherhemodynamic parameter such as left ventricular ejection fraction improved butwas not significant (p value=0.79).conclusion: pulmonary valve replacement can successfully restores theimpaired hemodynamic function of right ventricle which is caused by directconsequence of volume unloading in patient. pulmonary valve surgery inchildren with tetralogy of fallot who have moderate to severe pulmonaryregurgitation leads to an improvement of right ventricular function