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[Management of pulmonary stenosis in the correction of the tetralogy of Fallot].

Successful surgical correction of (la estenosis pulmonar en la tetralogía de Fallot), requires that the postoperative ratio between the (right ventricular pressure) and (left ventricular pressure) (PVD/PVI) be less than 0.70. By measuring the ring diameter and pulmonary branch on relation to the (superficie corporal) it is possible to predict the outcome of this ratio and therefore indicate whether or not it is necessary to increase (AP). This paper presents our experience with 24 patients subjected to total correction of (tetralogía de Fallot) from March of 1975 to the present using the above criteria. The average age was 7 years (ranging from 2 to 20). In all cases the (cresta supraventricular) was (resected). In 14 (58%) a (valvultomia pulmonar) was performed and in 9 patients (37) it was necessary to increase the ring and pulmonary branch of the pulmonary artery according to measurements taken. The post-operative relationship PVD/PVI was 0.2-0.3: 15%, 0.4-0.5: 60%, 0.6-0.7: 25% In no case was the ratio greater than 0.70. No significant difference was found between those cases requiring... (parche transanular) and those where such treatment was not necessary. Three patients (12%) died immediately following the operation. It is concluded that measurement of the diameter of the pulmonary ring in comparison to the (superficie corporal) is extremely useful in management during surgery of (estenosis pulmonar) in patients with (tetralogía de Fallot).

Humans↗
PubMed1993

[Architectonics of pulmonary vessels in pulmonary stenosis].

The authors aimed their work on the study of the architecture of pulmonary blood vessels and blood flow via pulmonary vascular network in patients with Fallot malformation. In 34 children with valvular stenosis of a. pulmonalis and in 12 children with Fallot tetralogy they analysed in detail their angiograms, paying attention to evaluation of the architecture of truncus pulmonalis and its branches, the discharging part of the right ventricle, and the state of the arterial phase of the pulmonary vascular network. On the basis of their results the authors explain the preferential blood distribution in Fallot's tetralogy by the displacement of the outflow part of the right ventricle to the right and by a greater amanation angle between the right branch of a.pulmonalis and its truncus. Better routing of blood into the left lung in patients with pulmonary valvular stenosis is according to the authors due to a greater emanation angle between the left branch of a.pulmonaris and its truncus. The authors analyse also the mechanism of formation of poststenotic dilatation of truncus pulmonaris and the left branch of a.pulmonaris in cases of valvular stenosis in infant age. (Fig. 4, Ref. 12.)

Angiocardiography↗