Tetralogy of Fallot repair results in activation of the renin-angiotensin-aldosterone system

• Published in: European heart journal Vol. 17; no. 9; pp. 1421 - 1425
• Main Authors: Mainwaring, R. D., Lamberti, J. J., Moore, J. W., Billman, G. F., Carter, T. L., Nelson, J. c.
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.09.1996
• Subjects: Aldosterone - analysis; Aldosterone - metabolism; Analysis of Variance; angiotensin; Angiotensin II - analysis; Angiotensin II - metabolism; Biological and medical sciences; Cardiology. Vascular system; Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava; effusion; Female; Heart; Humans; Infant; Linear Models; Male; Medical sciences; Postoperative Complications - physiopathology; Prognosis; Radioimmunoassay; renin; Renin - analysis; Renin - metabolism; Renin-Angiotensin System - physiology; Tetralogy; Tetralogy of Fallot - physiopathology; Tetralogy of Fallot - surgery; Human; Postoperative; Water; Pathophysiology; Cardiovascular disease; Exploration; Retention; Congenital disease; Renin angiotensin aldosterone system; Treatment; Sodium; Heart disease; Surgery; Fallot tetralogy; Complication; Repair; Child
• ISSN: 0195-668X; 1522-9645
• DOI: 10.1093/oxfordjournals.eurheartj.a015077

Fluid retention is a common problem following transannular patch repair of tetralogy of Fallot. The present study was undertaken to evaluate whether humoral substances may contribute to this process. Patients undergoing tetralogy of Fallot repair using a transannular patch technique were compared to patients undergoing simple ventricular septal defect repair. Hormone levels were determined by radioimmunoassay. Fluid retention was defined as pleural effusions persisting beyond 5 days. The data demonstrate that patients undergoing tetralogy of Fallot repair had elevated levels of anti-diuretic hormone, renin, angiotensin II, and aldosterone as compared to a group with ventricular septal defect. The elevation in hormone levels in the tetralogy of Fallot group was principally accounted for by those who developed effusions post-operatively. These results suggest that activation of the renin-angiotensin-aldosterone system may be one of the contributing factors to fluid retention following tetralogy of Fallot repair.