Correlation of severity of pulmonary regurgitation with right ventricular diastolic function in early post operative period in patients of tatralogy of fallot after total correction

Objective: To assess the occurrence of pulmonary regurgitation and right ventricular diastolic dysfunction in Tetralogy of Fallot after total correction and to correlate its severity with right ventricular diastolic dysfunction in early post operative period after total correction in TOF patients. Methods: We prospectively studied 38 TOF patients who has undergone total correction. Standard 2-Dimentional & doppler Trans thoracic echocardiographic assessment was done at seventh day , three month and six month after total correction . Pulmonary regurgitation severity, right ventricular diastolic dysfunction, right ventricular myocardial performance index, and tricuspid annular plane systolic excursion were assessed. Results: Most of the patients (50%) were < 5 year of age. 23 (60.5%) had none or mild pulmonary regurgitation while 15(39.5%) had moderate or severe pulmonary regurgitation. At 6 month follow up 86.8% patients had right ventricular diastolic dysfunction. Grade I, II and III right ventricular diastolic dysfunction was found in 31.6%, 31.6% and 23.7% respectively. Mean TAPSE and right ventricular myocardial performance index values at 6 month were 10.9±2.4mm and 39.07±7.8 respectively. The mean RVMPI was normal in none/mild pulmonary regurgitation severity group while it was abnormally high in mod/severe pulmonary regurgitation severity group. Spearman’s rank order correlation coefficient value for pulmonary regurgitation severity group and RV diastolic dysfunction grade was 0.438, 0.50, and 0.447 on 7thday, three month and six month follow up respectively. Conclusion: PR severity had moderate positive correlation with right ventricular diastolic dysfunction in early post operative period after total correction in TOF patients.