Study On The Right Cardiac Function Of Patients With Tetralogy Of Fallot Before And After Pulmonary Valve Sparing Surgery By Multimodal Ultrasonic Technology

Objective:The changes of right cardiac function in patients with Tetralogy of Fallot(TOF)before and after radical resection with pulmonary valve reservation were analyzed by multi-mode ultrasound technology,the clinical effect of radical resection with pulmonary valve reservation was discussed,and the feasibility of radical resection with pulmonary valve reservation was made clear,so as to provide guidance for clinical treatment and prognosis evaluation.Methods:A total of 30 children with TOF who underwent pulmonary valve resection for treatment in Jiangxi Children's Hospital from July 2017 to October 2019 were selected before surgery,1 week after surgery,3 months after surgery,and 6 months after surgery Echocardiographic examination.Analysis of right ventricular end-diastolic diameter(RVEDd),right ventricular end-diastolic volume(RVEDV),right ventricular end-systolic volume(RVESV),three-dimensional right before operation and 1 week after operation,3 months after operation,and 6 months after operation Ventricular ejection fraction(3D-RVEF),right ventricular end diastolic area(RVEDA),right ventricular end systolic area(RVESA),two-dimensional Right ventricular fractional area change(RVFAC),right ventricular Tei index and peak pulmonary artery forward blood flow peak Velocity,peak pressure difference of pulmonary valve across valve,degree of pulmonary valve regurgitation,etc;The statistical analysis of the research data was carried out through the SPSS22.0 software package.The measurement data with normal distribution was expressed as(x±S),the comparison of count data was by?~2 test,and the comparison between groups was by t test.Results:(1)At 1 week postoperatively,3 months postoperatively,and 6 months postoperatively,the RVEDd,RVEDV,RVESV,RVEDA,and RVESA of the patient were all reduced,and the difference was statistically significant compared with preoperative 0.05),but there was no significant difference between 1 week postoper-atively,3 months postoperatively,and 6 months postoperatively(p>0.05);(2)Peak velocity of pulmonary artery blood flow and pulmonary artery span after radical operation in children with TOF The valve peak pressure difference decreased compared with before operation,the difference was statistically significant(p<0.01),but the difference was not statistically significant at 1 week after operation,3 months after operation,and 6 months after operation(p>0.05).(3)The RVFAC and 3D-RVEF at 1 week after operation,3 months after operation,and 6 months after operation were significantly lower than those before operation,the difference was statistically significant(p<0.01),3 months after operation,There was a statistically significant difference between 6 months after operation and 1 week after operation(p<0.05),but the new balance gradually reached 3 months and 6 months after operation,and the difference was not statistically significant(P<0.05)).(4)The right ventricular Tei index decreased significantly at 1 week,3 months,and 6 months after operation,and the difference was statistically significant compared with that before operation(p<0.05);There was no significant difference between months(P>0.05),but they were all lower than 1 week after surgery,and the difference was statistically significant(P<0.05).Conclusion:(1)Pulmonary valve-preserving radical operation for the treatment of TOF can effectively improve RVEDd,RVEDV,RVESV,RVEDA and RVESA in children;meanwhile,it can effectively reduce the peak velocity of pulmonary artery forward blood flow and reduce the peak pressure difference of pulmonary artery transvalve.(2)The right cardiac function of children after TOF with radical pulmonary valve preservation was improved,RVFAC and 3D-RVEF decreased after operation,and reached a new balance in the near future.(3)The right ventricular Tei index of children after TOF-preserving pulmonary valve radical resection significantly decreased,and recently recovered well.