Influence of the Fontan Operation and Systemic - pulmonary Shunt on Ventricular Diastolic Functions in Patients with Single Ventricle [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 1997; 25(2): 101-107

Influence of the Fontan Operation and Systemic - pulmonary Shunt on Ventricular Diastolic Functions in Patients with Single Ventricle

Gülhis BATMAZ1, Ayşe SARIOĞLU1, İrfan Levent SALTIK1, Resmiye BEŞİKÇİ1, Yar.Barbaros KINOĞLU1, Tayyar SARIOĞLU1

In patients with single ventricle, Fontan's operation is a total physiologic corrective surgery. In this operation, because of the passive properties of the pulmonary circulation, diastolic functions of the ventricle have great importance. For this reason, we evaluated diastolic functions of the ventricle w ith echocardiography and investigated the relations between this parameters and ventricular geometry and systolic functions. Three groups, 10 patients (group Il) aged 4.77 ± 3.48 years having no operation, 12 patients (group III) 12.34 ± 11.18 years of age with systemic - pulmonary artery shunt and 21 patients performed Fontan operation aged 11.32 ± 6. 79 years constituted our study population. At a mean age of 6.56 ± 2.78 years, 21 children having no cardiac disease were accepted as control group. Hepatic venous, atrioventricular (AV) valves and pulmonary venous flow patterns were evaluated. For the hepatic and pulmonary venous flow, maximal velocity and velocity- time integral (VTI) were measured. Maximal velocity and VTI of early (E) and late (A) diastolic wave of the AV flow and the ratio of these components and the ratio of E velocity to stroke volume were calculated. In the Fontan's operation group, maximal velocity and VTI of hepatic venous flow were the lowest. There was no difference in these parameters for other patient groups and normal children. E velocity and E/A ratio were lower than normal for the patienis with single ventricle. There was no difference in the findings in terms of the presence of ventricular hypertrophy. In spite of older age and lowest heart rate, these findings showed that in the Fontan's operation group there was a diastolic dysfunction indicating relaxation abnormalities of the ventricle. In conclusion, in the single ventricle cases with Fontan's operation or systemic- pulmonary shunt, there was diastolic dysfunction of the ventricle. We thought that this dysfunction was related to ventricular hypertrophy and ischemic myocardial injury. In Fontan operation group the velocity of systemic venous flow was lower than normal, indicaling a passive pulmonary flow. For evaluation of the diastolic functions, the measurements from the systemic AV valve were sufficient and easy.


How to cite this article
Gülhis BATMAZ, Ayşe SARIOĞLU, İrfan Levent SALTIK, Resmiye BEŞİKÇİ, Yar.Barbaros KINOĞLU, Tayyar SARIOĞLU. Influence of the Fontan Operation and Systemic - pulmonary Shunt on Ventricular Diastolic Functions in Patients with Single Ventricle. Turk Kardiyol Dern Ars. 1997; 25(2): 101-107
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