The Role of the Diameters of Pulmonary Arteries Measured by Echocardiography in Total Correction of tetralogy of Fallot

Poorly developed pulmonary arteries will not accomodate the total cardiac output following total correction of tetralogy of Fallot (TOF). In this context, the role of the index of pulmonary arteries (IPA) calculated by dividing the combined diameters of right and left pulmonary arteries to the diameters of descending thoracic aorta at the diaphragmatic level was investigated from the standpoint of mortality in total correction of 120 patients with TOF. Three patients who died because of hemorrhage or ventricular fibrillation were excluded from evaluation. Of 68 patients whose IPA measured 1.5 and above, none died; of 49 patients whose IPA measured below 1.5, six patients died (% 12.2) because of low cardiac output (p<0.05). Though in the latter group the index in those who died did not differ significantly from that in the survivors, it was concluded that the palliative surgical treatment might be preferred initially for those patients whose IPA is below 1.5.