J.Jpn. Surg. Soc.
ISSN 1880-1129

[Abstract] [Full Text PDF] （in Japanese / 5157KB） [Members Only And Two Factor Auth.]

J.Jpn. Surg. Soc.. 80(1): 71-79, 1979

Original article

TRICUSPID REGURGITATION FOLLOWING SURGICAL TOTAL CORRECTION FOR TETRALOGY OF FALLOT AND AN EXPERIMENTAL STUDY ON TRICUSPID REGURGITATION

1) Second Department of Surgery, Yamagata University School of Medicine
2) Second Department of Surgery, Niigata University School of Medicine

Takao Irisawa1), Tohru Satoh1), Mikio Katagiri1), Chiharu Nakamura1), Minoru Kobayashi1), Masahiko Washio1), Tetunosuke Matukawa2), Shinichi Ohtani2), Shoji Eguchi2)

Two cases of heart failure from tricuspid regurgitation that developed following surgical total correction for tetralogy of Fallot have been experienced. Because of diffuse, right ventricular outflow tract stenosis, the patients had undergone operation for outflow tract construction with a simple enlongate prosthetic patch and, five months afterwards, the 13-year-old patient developed symptoms of right-sided heart failure with moderate tricuspid regurgitation due to moderately elevated right ventricular pressure and enlargement of the right ventricle. Medical treatment led to complete cure of the right-sided heart failure ten months after the operation in this case. In the other patient, 11 months old at the time of surgical treatment, right-sided heart failure recurred with evidence of marked tricuspid regurgitation due to pronounced elevation of right ventricular pressure and enlargement of the right ventricle seven months after operation. In spite of medical treatment the right-sided heart failure progressed to its termination at eight months after the operation.
The influence of tricuspid regurgitation on hemodynamics was investigated in dogs with a synthetic fabric graft implanted as bypass between the right venticle and the right atrium. The volume of regurgitation in tricuspid regurgitation was noted to increase in propetion to elevation of the right ventricular pressure with consequent decline in cardiac output ; hence a marked influence upon the normal hemodynamics. The experiment also revealed that, in tricuspid regurgitation whre the regurgitation rate was approximately 0.5, the cardiac output and aortic pressure decreased by no more than about 30 and 10 per cent approximately despite increase volume load of the right ventricle, thus indicating an adequate hemodynamic compensation.

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