Hi all,

I request your second opinion on the the data on the post operative
condition of my son. In particular the long term prospects.  Our cardio
thinks there is a chance he might need a pulmonary valve before his 5th
birthday.

I previously posted about the condition of my son before operation
under the following post:

http://groups.google.com/group/sci.med.cardiology/browse_frm/thread/b99536c03395
e167/e070de30d6af1c15?lnk=st&q=tetralogy+of+fallot&rnum=1&hl=en#e070de30d6af1c15

In late August 2004 when my son was 13 months old he was operated on to
correct his condition (London's Harley Street Clinic).  The operation
was succesful and he was discharged after 2  weeks.  We were advised to
have him looked at by his main cardio after 3 months or so.  This we
did and the cardio advised our son be checked at 3 months intervals
which we have done since then.  Today (18 months post op) the cardio
has lengthened th e intervals to 6 months which is good news for us.
Today's report is as follows (following the same numbering as the above
link, with the addition of number 9 which has now been added):

1. Intraventricular septum.  Surgical patch noted with no residual
shunt.  There is no paradoxical contractile pattern.

2. Aortic valve.  Mildly dilated.  Symmetrical and tricuspid with no
signs of prolapse    The
sinusses of Valsalva are normal and the origins of the RCA and LCA are
noted. The LCA does not show branching into the LAD adn LCX the there
appears to be a small early branch of the RCA which might represent a
small conal bracnch or branch of the LAD. The opening pattern is
complete and the valve closes centrally.  There is no AS or AR.

3. Aortic arch.  Appears right sided and intact with the classical
branching pattern of the head and neck vessels.  There is no evidence
of coarctation.

4. Right Ventricle.  RVEDD = 12 mm and slightly dilated with RV free
wall hypertrophy.  The
contractility pattern is normal with systolic.

5. Tricuspid valve. Morphologically normal. There
is no TS and mild TR, RSVP = 50 MMhg.

6. Pulmonary valve. Status PO shows residual PS of 37mmHg. There is
moderate PR.

7. Pulmonary artery branches. The MPA measures 12 mm and the LPA is 6
mm and
the RPA is 5 mm.

8. There is no evidence of a PDA or MAPCAs

9. Pericardium. Normal.

SUMMARY: POST OPERATIVE TETRALOGY OF FALLOT WITH:

*  RESIDUAL VALVULAR PS WITH PG = 41 mmHg, MEAN PG=24mmHg
* MODERATE PR WITH MAX GRADIENT=15mmHg
* MILD TR, RSVP=50mmHg
* RV AND RA SLIGHTLY DILATED
* MILD MR
* NO RESIDUAL VSD
* NO RESIDUAL ASD
* NO PDA

I have left out some of the items which appear normal to the
cardiologist.  If necessary I will put them down when asked.

The baby was born at 1.85kg (4 lb). Today at 32 months he is 12.8kg
(28lb)

Thanks and God bless you all.