Serial Cardiac Catheterizations and Exercise Hemodynamics after Correction of Tetralogy of Fallot

Abstract

Eleven patients had right heart catheterization an average of 13 mo after total correction of tetralogy of Fallot, and the procedures were then repeated an average of 7 years postoperatively. In the intervening time there was generally no important change in the pressure gradient between the right ventricle and pulmonary artery or in right ventricular systolic pressure. Mean right atrial pressure tended to fall with time. Arteriovenous oxygen difference at rest was lower at the second study, and the resting cardiac output was generally normal. One patient with a persistent ventricular septal defect had progressive hemodynamic deterioration between the two studies. Exercise performance up to 10 years postoperatively was also assessed. The relationship between oxygen consumption and cardiac output was usually normal, but exercise magnified the right heart's filling pressure abnormalities. In the absence of an easily demonstrable ventricular septal defect, right heart hemodynamics were either stable or improved up to 10 years postoperatively. The exercise response of cardiac output was usually normal at moderate work loads.