Research in Medicine

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Background: Exercise test is the only means of assessing a child's physical functional ability. All other cardiovascular tests are performed during the resting phase and do not appear to be strong concurrence of homodynamic data to physical performance. The most common exercise protocol utilizing in children is Bruce treadmill protocol and work capacity is best evaluated by maximal exercise. Materials and methods: Forty patients after total correction for Tetralogy of Fallot (TOF) were selected. In 19 patients (11 males and 8 females) surgery was performed with and in 21 patients (11 males and 10 females) surgery was performed without transannular patch. Maximal treadmill exercise (Bruce protocol) was performed in these two groups of patients and results were compared. Results: Of 19 patients with transannular patch, 10 (52.6%) had PS (pulmonary stenosis) and 14 (73.7%) had PI (pulmonary insufficiency). These figures were 28.6% and 33.3% for the other group. In patients with transannular patch, mean maximal blood pressure during exercise test was 124.8mmHg, however in the other group it was 132mmHg. Conclusion: There were statistically significant differences between the prevalence of PI and mean maximal blood pressure in two groups of patients. Although working capacity was better in patients operated without transannular patch but there was no statistically significant differences. The better exercise test results in patients operated without transannular patch is related to lower prevalence of PI and PS in this group.

Keywords: Tetralogy of Fallot, Transannular patch, Working capacity

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