Abstrakt
We studied lung function in 41 patients, aged 6-27 years, 1-5 years after intracardiac surgical repair (ICR) of tetralogy of Fallot (TOF) and about 5 years after the establishment of the Pediatric Cardiac Center in Prague. The measurements included vital capacity (VC), total lung capacity (TLC), functional residual capacity (FRC), residual volume (RV), forced expiratory flows (FEF), specific airway conductance (SGaw), lung recoil pressure (Pst), and specific static lung compliance (SC(Ist)).
Single or mutiple abnormal lung function parameters were found in 83% of patients. Lung function was not related to shunting operations prior to ICR, hemoglobin concentration, and hematocrit, and had no specific pattern.
Pst at 100% TLC and 90% TLC declined with increasing age at ICR and at lung function testing, while SC(Ist) rose, as did the ratio FRC/TLC. Fifteen patients were studied before and after surgery.
Single or multiple lung function tests were abnormal in 93% before and in 84% after ICR. After ICR the ratios FRC/TLC and also RV/TLC, FEF at 25% VC, and FEF at 60% TLC were less frequently abnormal, while Pst at 100% TLC and at 90% TLC, as well as SGaw and TLC, were more frequently abnormal after ICR.
The results indicated a regression of smaller airway obstruction and lung hyperinflation after ICR. The evolution of abnormally compliant (emphysematous) lungs with growth of the patients might be a sign of permanent sequelae of early lung damage from abnormal pulmonary hemodynamics.