Abbaszadeh Reza, Askari-Moghadam Raheleh, Moradian Maryam, Mortazaeian Hojat, Qomi Mohammad Reza Safaei, Omidi Negar, Khalili Yasaman, Tahouri Tahmineh
Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
Department of Paediatrics, Arak University of Medical Science, Arak, Iran.
Egypt Heart J. 2023 Nov 29;75(1):95. doi: 10.1186/s43044-023-00423-9.
Pulmonary regurgitation is the most common complication after the complete repair of tetralogy of Fallot, and severe pulmonary regurgitation after surgery requires pulmonary valve replacement. In this retrospective observational, cross-sectional study, we included a total of 56 children aged 6 years or younger who underwent complete repair of TOF at Shahid Rajaei Cardiovascular Medical and Research Center in Tehran, Iran. Preoperative dual-source computed tomography was used to measure the McGoon ratio and Nakata index. The patients were divided into two groups based on the severity of postoperative pulmonary regurgitation, as estimated by trans-thoracic echocardiography: the severe pulmonary regurgitation group and the non-severe pulmonary regurgitation group. The McGoon ratio and Nakata index were then compared between the two groups.
When comparing the two groups, we found that the corrected right pulmonary artery diameter, main pulmonary artery diameter, and McGoon ratio in the non-severe pulmonary regurgitation group were higher than in the severe pulmonary regurgitation group. However, none of these differences were statistically significant. Additionally, other variables, including the corrected left pulmonary artery diameter and Nakata index, showed higher measurements in children with severe pulmonary regurgitation, but again, the differences were not statistically significant.
This study indicates that pulmonary arteries diameter, Nakata index, and McGoon ratio were not significantly correlated with the severity of pulmonary regurgitation after the complete repair of tetralogy of Fallot.
肺动脉反流是法洛四联症完全修复术后最常见的并发症，术后严重的肺动脉反流需要进行肺动脉瓣置换。在这项回顾性观察性横断面研究中，我们纳入了总共56例6岁及以下在伊朗德黑兰的沙希德拉贾伊心血管医学与研究中心接受法洛四联症完全修复术的儿童。术前使用双源计算机断层扫描测量麦戈恩比率和中田指数。根据经胸超声心动图评估的术后肺动脉反流严重程度，将患者分为两组：严重肺动脉反流组和非严重肺动脉反流组。然后比较两组之间的麦戈恩比率和中田指数。
比较两组时，我们发现非严重肺动脉反流组的校正右肺动脉直径、主肺动脉直径和麦戈恩比率高于严重肺动脉反流组。然而，这些差异均无统计学意义。此外，其他变量，包括校正左肺动脉直径和中田指数，在严重肺动脉反流患儿中显示出更高的测量值，但同样，差异无统计学意义。
本研究表明，法洛四联症完全修复术后肺动脉直径、中田指数和麦戈恩比率与肺动脉反流严重程度无显著相关性。
