Does an aortopulmonary shunt before repair of tetralogy of Fallot limit exercise tolerance in long-term survivors?

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  • Author(s): Leyh R;Leyh R; Böhle A; Sievers HH; Bernhard A
  • Source:
    Cardiovascular surgery (London, England) [Cardiovasc Surg] 1995 Aug; Vol. 3 (4), pp. 369-74.
  • Publication Type:
    Journal Article
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: Elsevier Ltd Country of Publication: England NLM ID: 9308765 Publication Model: Print Cited Medium: Print ISSN: 0967-2109 (Print) Linking ISSN: 09672109 NLM ISO Abbreviation: Cardiovasc Surg Subsets: MEDLINE
    • Publication Information:
      Publication: Exeter : Elsevier Ltd
      Original Publication: London : Butterworth-Heinemann, c1993-c2003.
    • Subject Terms:
      Exercise Test*; Hemodynamics/*physiology ; Postoperative Complications/*physiopathology ; Pulmonary Diffusing Capacity/*physiology ; Tetralogy of Fallot/*physiopathology; Adolescent ; Adult ; Anaerobic Threshold/physiology ; Angiography ; Blood Flow Velocity/physiology ; Echocardiography ; Female ; Follow-Up Studies ; Humans ; Lung/blood supply ; Male ; Palliative Care ; Postoperative Complications/mortality ; Survival Rate ; Tetralogy of Fallot/mortality ; Tetralogy of Fallot/surgery
    • Abstract:
      The purpose of this study was to evaluate the impact of an aortopulmonary shunt on exercise capacity in long-term survivors after total repair of tetralogy of Fallot (17.6(2.0) years' follow-up). Submaximal exercise tests, pulmonary function tests, lund diffusion tests for carbon monoxide, two-dimensional and Doppler echocardiography were performed in 12 patients with an aortopulmonary shunt (group A) and in 21 patients (group B) without a shunt before repair. There were no significant differences in two-dimensional and Doppler echocardiographic findings nor in pulmonary function. Group A showed a significantly lower diffusion capacity of the lung for carbon monoxide at rest (66.2(13.0)% versus 84.1(9.5)%; P < 0.01) and at the anaerobic threshold (71.8(11.0)% versus 87.2(9.8)%; P < 0.01) as well as a significantly reduced physical working capacity at ventilatory anaerobic threshold (1.6)(0.32) W/kg versus 2.41(0.43) W/kg; P < 0.01). A negative correlation was observed between the duration of palliative shunts and diffusion capacity of the lung for carbon monoxide at rest at ventilatory anaerobic threshold (r = -0.8635 and -0.9108 respectively). A shunt placed before definitive repair impairs the long-term working capacity, probably by diminishing the diffusion capacity of the lung for carbon monoxide, especially if the shunt is in place for more than 20 months.
    • Publication Date:
      Date Created: 19950801 Date Completed: 19951206 Latest Revision: 20191023
    • Publication Date:
      20221213
    • Accession Number:
      10.1016/0967-2109(95)94153-n
    • Accession Number:
      7582989