| Objective Tetralogy of Fallot (TOF) is the most common right and left shunt cyanotic congenital heart disease. It is very important for TOF to accuratelly evaluate the heart function in the clinical diagnosis and treatment. Tei index,also known as myocardial performance index, was able to reflect systolic and diastolic heart function.The aim of this research is to evaluate the heart function of surgical consecutive patients with TOF,interpret clinical significance and to study the influence of Tei index between transannular patch and single outflow tract patch . At the same time,to analyze consistency of tissue Doppler and pulsed Doppler Tei index valued cardiac function in patients with TOF.Methods From December of 2004 to March of 2006, there are 38 patients of TOF without other accompanied abnormity were collected for this study. All patients were treated by radical surgical procedure with hypothermic cardiopulmonary bypass, recorded their operative time, aortic cross-clamping time, mechanical ventilation time, ICU stay time and drug supplement time. The clinical and echocardiographic data were collected at preoperative, six months and one year after operation, using tisssue and pulsed Doppler to detect Tei index of the left ventricle and right ventricle. The results were analysed with SPSS 11.0 statistical analysis software.Results 1. 38 patients had surgery .There were no statistically significance in aortic cross-clamping time, cardiopulmonary bypass time, mechanical ventilation time, ICU time and drug supplement time. The average operative time was 106.4 ± 22.7min, aortic cross-clamping time was 58.4 ± 13.2min, cardiopulmonary bypass time was 77.4 ± 18.5min, mechanical ventilation time was 49.4 ± 6.5h, ICU time was 1.7 ± 2.4d , drug supplement time was 56.4 ±12.6min.2. The volume of left and right ventricular had taken noticeable changes in six months after operation and one year after operation. The left ventricular diameter (LVD) were significantly increased, The ventricular diameter (RVD) decreased. RV/LV decreased, Isovolumetric contraction time(ICT)and Isovolumetric relaxation time(IRT) diminished,but ejection faction(EF) had little change than before.3.The left and right ventricular pulsed Doppler and tissue Doppler Tei index reduced significantly in six months after operation and one year after operation, compared with preoperation the difference was statistically significant (P <0.05);compared Tei index in six months with one year after operation, the difference was more statistically significant (P <0.01). The comparison between pulse Doppler Tei index and tissue Doppler Tei index had no significant difference (P>0.05); The pulse Doppler Tei index and tissue Doppler Tei index showed very high correlation (P <0.001)by correlation analysis method .4. The number of transannular patch were 27, the total of single outflow tract patch Widened were 11 . The right ventricular IRT and ICT in transannular patch patients longer than simple outflow tract patch widened patients. Tei index of right ventricular also appeared the same changes, the difference was statistically significant. Of these patients, The IRT,ICT and Tei index of left ventricular showed no significant difference (P> 0.05).Conclusions 1.For patients with TOF,the heart function improved significantly postoperative comparing with preoperative. Left and right ventricular end-diastolic diameter and left and right ventricular function after operation increased significantly. Tei index decreased,but eject faction almost not diminished after operation.2.Tissue Doppler Tei index and pulse Doppler Tei index had highly correlated. They were both used to evaluate heart function in patients with TOF.3. The surgical treatment of transannular patch could influenced right ventricular function, Tei index had significant difference. But less impact on the left ventricle. Tei index had no difference.
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