Hemodynamic response to exercise in patients 2 to 6 years after Rastelli operation.

We studied hemodynamic response to exercise in eight patients who had undergone Rastelli operation 2 to 6 years before this study. Endurance time for the treadmill test was below the low limit of two standard deviations of our normal value in 5 out of 7 patients. On bicycle ergometer exercise test during catheterization, cardiac output increased from 3.8 +/- 0.96 liter/min/m2 to 6.5 +/- 1.7 liter/min/m2 when heart rate increased 81 +/- 10 to 123 +/- 17, the latter reaching 71% of the maximum value. Right ventricular pressure increased from 85 +/- 38 mmHg to 114 +/- 45 mmHg, along with elevation of the enddiastolic pressure (+5 +/- 4 mmHg). Right-sided ventricular ejection fraction increased in 3 out of 6 patients, while left-sided ventricular ejection fraction increased in 4 out of 7 patients. Thus, ventricular pump function does not respond normally to physical activity in many patients after Rastelli operation.