Siyami Ersek Göğüs Kalp ve Damar Cerrahisi Eğitim ve Araştırma Hastanesi, Kalp ve Damar Cerrahisi Kliniği, İstanbul

Background: Restricted right ventricle physiology is defined as antegrade pulmonary flow caused by compromised right ventricular compliance during late diastole. Methods: Thirty-four tetralogy of Fallot patients with total correction were included in our study. In all patients, we investigated right ventricular functional status, pulmonary valve regurgitation, antegrade diastolic pulmonary flow measurements echocardiographically as well as QRS durations electrocardiographically. We compared the statistical differences of QRS duration, pulmonary regurgitation and right ventricular dilatation between the restricted and unrestricted right ventricle group. Operation age, follow-up periods, transannular patch utilizations, postoperative pharmacological positive inotropic agent need, and cross clamp periods were all analyzed. Results: There was no difference between the groups with and without antegrade diastolic pulmonary flow, in terms of follow-up period, age, transannular patch utilization, QRS duration and cross clamp period. There was a significant difference in terms of pulmonary regurgitation and right ventricular dilatation between the two groups. When the cases with and without pulmonary valve regurgitation were compared, there was no difference in terms of operative age, whereas significant difference was found in terms of QRS duration, right ventricular dilatation and transannular patch utilization. Conclusion: In spite of its early negative effects, right ventricular restriction following total correction of tetralogy of Fallot may decrease morbidity by protecting from late complications. For this reason, it has been reported that cardiac performance is better preserved in restricted right ventricle physiology cases.