The tetralogy of Fallot occurs in approximately 1 in 3,600 live births and accounts for 3.5% of infants born with congenital heart disease. The objective of this investigation was to assess the clinical characteristics and evolution of patients with tetralogy of Fallot at a teaching hospital without cardiac surgery facilities and compare them with the reports from high technology hospitals.Material and Methods. Observational descriptive cross section study of the Hospital del Nino Jesus (Tucuman, Argentina) Cardiology Service data base available at 2006. The analysis involved 46 patients with tetralogy of Fallot diagnosis.Results. Of the 46 patients, 13% were lost in the followup period; 37% had initial palliative arterial-pulmonary shunt, and 67% patients underwent complete repair of tetralogy of Fallot. The mean age at palliative procedure was 0.5 years (range 4 days to 5 years) and the mean age at complete repair was 3.9 years (range 1 to 11 years). Mean time from the palliative procedure to the complete repair was 2.8 years (range 6 months to 6 years). At the long term follow- up, 64% of patients who underwent complete repair had right ventricular dilation associated with chronic pulmonary regurgitation.Conclusions. The mean age at palliative procedure, the mean age at complete repair, and the mean time from the palliative procedure to the complete repair were higher than the reports from the available literature, but the frequency of patients with right ventricular dilation associated with chronic pulmonary regurgitation is similar to previous reports. There have been tremendous improvements in the care of patients with CHD. To maintain the expectations set for our patients, systems of care must be developed. Registry and academic databases will ensure that the quality of care is good and will help us to realize our expectations for future patients.

The goals of this study were to characterize normal patterns of longitudinal motion of atrioventricular annuli in the young, establish reference values and assess growth-related changes (n = 40). Sensitivity to changes in right ventricular volume and pressure load was assessed in patients with atrial septal defect (ASD) (n = 25) and with primary pulmonary hypertension (PPH) (n = 20). M-mode of the annuli were obtained from apical views. In healthy subjects, longitudinal %displacement decreased with growth, lateral tricuspid annulus had highest %displacement, velocity of annular descent did not change with growth, tricuspid lateral annulus had the highest velocity of descent, only ascent velocity of the lateral tricuspid annulus decreased with growth, velocities of ascent for the lateral annuli were similar and higher than the septum, and heart rate had no effect on parameters tested. In patients with ASD, the findings were an exaggerated normal pattern. In patients with PPH, %displacement and ascent velocities were blunted. Our results demonstrate the utility of this technique to assess annular dynamics in pediatric patients.