Patient selection: infant with pulmonary atresia and an intact ventricular septum
Procedure: biventricular repair
Parameters:
(1) body weight in kilograms
(2) tricuspid valve diameter in mm (apical 4-chamber view)
(3) mean tricuspid valve diameter for population and standard deviation
(4) mitral valve diameter in mm (apical 4-chamber view)
tricuspid to mitral valve ratio =
= (diameter of tricuspid valve) / (diameter of mitral valve)
z score for tricuspid valve =
= ((patient tricuspid valve diameter) - (mean tricuspid valve diameter)) / (standard deviation for tricuspid valve diameter)
|
Parameter
|
Successful Repair
|
Unsucessful Repair
|
|
body weight
|
2.9 to 4.1 kg (mean 3.5)
|
2.4 to 3.4 kg (mean 2.9)
|
|
tricuspid valve z-score
|
-2.2 to 0.8
|
-3.5 to -1.1
|
|
tricuspid to mitral valve ratio
|
0.6 to 1.0
|
0.4 to 0.6
|
Predictors of a successful outcome:
(1) higher body weight
(2) higher tricuspid valve z-score
(3) higher tricuspid to mitral valve ratio (>= 0.6)
Limitations on the use of the z-score:
(1) Accurate population data may not be available.
(2) The patient may not be represented by the population studied.
