E0036628

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ハイ シンチスキャニングホウ ニ ヨル ファロー シビショウ コンチジュツゴ ノ follow-up

FOLLOW-UP STUDY OF THE INTRACARDIAC REPAIR OF TETRALOGY OF FALLOT BY SCINTILLATION LUNG SCANNING

Japanese (日本語)

Medical journal of Kobe University

40(2)

249-261

1979-06

Intracardiac repair of tetralogy of Fallot has proved effective in relieving patients' symptoms, but the nature of the anomaly is apt to cause residue and sequelae. Therefore, in most cases, long term postoperative follow-up study by the proper examination is mandatory. To evaluate patients' postoperative condition, cardiac catheterization and angiocardiography are useful. However, the invasive character of these examinations make it difficult to perform frequently. From 1967 to 1977, the author performed postoperative scintillation lung scanning in 51 cases with tetralogy of Fallot along with cardiac catheterization and angiocardiography to investigate if this non-invasive examination was valid for evaluating the patients' postoperative condition. The 51 patients were divided into 4 groups (group 1 ; those with severe distribution disturbance group 2 ; those with moderate distribution disturbance, group 3 ; those with mild distribution disturbance, group 4 ; those with no distribution disturbance), according to the grade determined by postoperative regional pulmonary blood flow distribution on scintillation lung scanning. In each group, the residue and sequelae such as pulmonic stenosis (PS), pulmonary hypertension (PH), peripheral pulmonary st~osis (PPS), pulmonary insufficiency (PI), and aneurysmal dilatation of the right ventricular outflow tract (RVOD) were studied in association with the functional class of New York Heart Association (NYHA). In the 6 cases of group 1, there were 2PS, 3PH, 2PPS, 5PI and 5RVOD. Every 6 cases had more than 2 residue and/or sequelae and 5 cases belonged to the class II - III of NYHA. In most of these cases, large patch was used to enlarge the right ventricular outflow tract. In the 7 cases of the group 2, there were 3PS, 2PH, IPPS, 5 PI and 1 RVOD. All of them had no subjective symptoms. In the 38 cases of the group 3 and 4, there were 2PS, 2PH;10PI and 4RVOD. All of them had no subjective symptoms. To date, the author has concluded that because the scintillation lung scanning can reflect the above mentioned residue and sequelae, especially PPS and RVOD well, this non-invasive examination is useful in the postoperative follow-up study of tetralogy of Fallot.

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