الفهرس | Only 14 pages are availabe for public view |
Abstract Children with valvular pulmonary stenosis have right ventricular diastolic filling abnormalities, which may be due to either right ventricular hypertrophy or right ventricular outflow tract obstruction. It is postulated that children with right ventricular hypertrophy caused by valvular pulmonary stenosis have abnormalities of right ventricular diastolic filling. Furthermore, if these abnormalities are caused by hypertrophy alone then RY diastolic filling should be unchanged immediately after successful relief of pulmonary stenosis by PBV (Vermillion et al, 1992 and Pac eta), 2000). This work aimed at assessment of right ventricular diastolic functions in congenital severe PS before and after PBY as well as evaluation of the effectofPBY on right ventricular diastolic functions. To achieve these aims, this study was conducted from October 2003 to April 2005 and it included 38 patients from whom 26 patients were included and 12 patients were excluded; only patients with isolated valvular PS with a transvalvular systolic gradient > 70 mmHg were included. Before PBY, clinical as well as radiological and BCG evidences of PS and RYH were clearly demonstrated in our patients. Six months ihereafter, chest x-ray films and EeG showed significant regression of RVH with improvement of pulmonary blood flow, yet when compared with control subjects, RYW thickness was still significantly increased in patients with PS. ::;;:’.’’- . . ,.”.~,:’,’.” One day before PBY, our patients showed diastolic filling abnormalities when compared to control subjects. This diastolic dysfunction was evidenced by increased peak A velocity (72.5 vs 41.5cm/sec, P<O.OOI), decreased EtA velocity ratio (0.84 vs 1.6, P<O.OO 1), decreased acceleration time of peak E (66A4± 12.21 vs 74.S4± 14.06 ms, P<O.OS), and decreased deceleration time of peak E (61.76±12.32 vs 85.9S±13.83 ms, P<O.OOl) in patients versus control subjects respectively. |