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Ventricular dysfunction after surgical repair of Fallot's Tetralogy: a morfological and clinical study


Fallot's tetralogy is a congenital heart defect that presents high mortality for those children who are not submitted to surgical repair. Less than one fourth of the patients could be expected to survive up to the first decade of life. Nowadays, with surgical treatment, the overall mortality varies from 1 to 6%. A subgroup of patients, however, after surgical repair, develop low cardiac output and a difficult and prolonged post-operatory course, with high morbimortality due to ventricular dysfunction. The reason for this outcome is unclear. Many factors may be involved: myocardial remodelling, intra-operative injuries, residual lesions. In order to to know the real incidence and recognize the risk factors for the evolution with ventricular dysfunction, and mainly to determine how the myocardial remodeling would relate to the ventricular dysfunctions, this project was devised. We will evaluate 30 children before and after the surgical repair of Tetralogy of Fallot at the Heart Institute of São Paulo University (USP), in a prospective way, including microscopical tissue analysis. Doppler echocardiography exam will be performed to evaluate the ventricle function. Blood troponine levels will be determined to evaluate the intra-operatory hypoxic isquemic injury. The cases will be divided according the presence or absence of ventricular dysfunction and the variables analysed accordingly. The morphological aspects will be compared with biopsies from specimens of normal hearts from the Pathological laboratory specimens. (AU)

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(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
KNOLL FARAH, MARIA CECILIA; PINHEIRO CASTRO, CLAUDIA REGINA; MOREIRA, VALERIA DE MELO; BINOTTO, MARIA ANGELICA; GUERRA, VITOR COIMBRA; RISO, ARLINDO DE ALMEIDA; MARCIAL, MIGUEL BARBERO; LOPES, ANTONIO AUGUSTO; MATHIAS, JR., WILSON; AIELLO, VERA DEMARCHI. The Impact of Preexisting Myocardial Remodeling on Ventricular Function Early after Tetralogy of Fallot Repair. Journal of the American Society of Echocardiography, v. 23, n. 9, p. 912-918, . (05/01476-2)
MARIA CECÍLIA KNOLL FARAH; CLÁUDIA REGINA PINHEIRO DE CASTRO; VALÉRIA MELLO MOREIRA; ARLINDO DE ALMEIDA RISO; ANTONIO AUGUSTO BARBOSA LOPES; VERA DEMARCHI AIELLO. O miocárdio na tetralogia de Fallot: estudo histológico e morfométrico. Arquivos Brasileiros de Cardiologia, v. 92, n. 3, p. 169-177, . (05/01476-2)

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