Incidence of right ventricular (RV) dysfunction in early postoperative period after Tetralogy of Fallot (TOF) repair ranges from 28 to 63%. Echocardiography is the first-line tool for the assessment of RV function in early postoperative period. As speckle tracking echocardiography (STE) has emerged as a new promising tool for assessing myocardial performance and is independent of geometric assumptions and angle dependence, it is more sensitive for detecting changes in myocardial performance than conventional echocardiographic parameters of RV function. The current study demonstrates echocardiographic parameters assessed by conventional two-dimensional (2D) echocardiography and STE in patients before and after TOF repair.
Materials and methods
Fifty-nine consecutive patients planned for complete intracardiac repair for TOF were enrolled in this prospective cohort study. The 2D echocardiography and STE were performed a day prior to TOF repair, in the early postoperative period between days 3 and 7 and after discharge at 3 months.
The median age of patients was 6 years, with 57.6% males (34/59). Baseline hemoglobin and room air oxygen saturation were 17.7 ± 3.7 gm% and 79.4% ± 8% respectively. Two patients did not survive the procedure (3.4%). Right ventricular longitudinal peak systolic strain (RV LPSS) in early postoperative period was significantly decreased in all segments of both septal and lateral wall. However, RV LPSS assessed at midterm follow-up at 3 months postoperatively significantly improved in all segments of RV compared with assessment done in the early postoperative period, and was significantly better than preoperative values in all three segments of the septal wall.
Our study shows that the use of 2D strain or speckle tracking is a feasible and easy-to-implement technique for the evaluation of RV function after TOF repair.
How to cite this article
Negi SL, Puri K, Mandal B, Rana SS, Barwad P. Right Ventricle Segmental Strain Trends in Patients undergoing Tetralogy of Fallot Repair: An Observational Study. J Perioper Echocardiogr 2016;4(2):45-50.