Background
Opinions regarding the optimal time for the repair of tetralogy of Fallot vary. A
debate also exists about the timing of repair for the asymptomatic infant.
Methods
This study included 183 patients with tetralogy of Fallot. All patients were subjected
to clinical examination with measurement of oxygen saturation, 12-lead ECG, plain
chest x-ray, and complete laboratory investigation. Echocardiography and cardiac catheterisation
were indicated if there was an inability to reach diagnosis by echocardiography, suspicion
of coronary anomaly, evaluation of distal pulmonary arteries or suspicion of major
aorto-pulmonary collaterals. Complete repair was done in all patients. Patients were
divided into two groups for comparison. Group 1 (147 patients, 1-year-old or less),
and Group 2 (36 patients older than 1 year).
Results
Three patients died in Group1 (2.04%) while there was no early mortality in Group
2 patients. Six patients in Group 1 (4.08%) were reoperated for significant residual
or recurrent right ventricular outflow stenosis, three patients (2.04%) were reoperated
for residual significant shunt, and three patients (2.04%) were reoperated for residual
significant stenosis and residual significant shunt. That is in addition to three
patients (2.04%) who had significant tricuspid regurgitation, three more patients
(2.04%) who needed a permanent pacemaker implantation, and nine patients (6.1%) who
had significant postoperative pulmonary valve regurgitation. On the other hand, for
Group 2 patients, there were only three patients who were reoperated for postoperative
restenosis and significant shunt, three patients who were reoperated for permanent
pacemaker implantation, and another two patients who had insignificant restenosis
to be followed up.
Conclusions
Early complete tetralogy of Fallot repair can be accomplished with a low mortality.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Heart, Lung and CirculationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Early primary repair of tetrallogy of Fallot.Ann Thorac Surg. 1988; 45: 235-241
- What is the optimal age for repair of tetralogy of Fallot?.Circulation. 2000; 102: 123-129
- Mavroudis C. Backer Carl L. Tetralogy of Fallot in Pediatric Cardiac Surgery. 3rd edition. Mosby, 2003: 383-397
- Repair of tetrallogy of Fallot in neonates and young infants.Circulation. 1999; 100: 157-161
- Surgery for tetralology of Fallot at less than six months of age.J Thorac Cardiovasc Surg. 1994; 107: 1291-1300
- Neonatal repair of tetralology of Fallot results in improved pulmonary artery development without increased need for reintervention.Eur J Cardiothoracic Surg. 2005; 28: 394-399
- Repair of tetralogy of Fallot with anomalous coronary arteries coursing across the obstructed right ventricular outflow tract.Pediat Cardiol. 2005; 26: 537-542
- Right ventricular outflow tract after non-conduit repair of tetralogy of Fallot with coronary anomaly.Ann Thorac Surg. 2000; 70: 723-726
- Complete repair of tetralogy of Fallot in infancy.Interact Cadiovasc Thorac Surg. 2004; 3: 470-474
- Early one-stage repair of tetralogy of Fallot.Med Wieku Rozwoj. 2005; 9: 161-169
- The indication and technique in total correction of tetralogy of Fallot: experience in 212 patients.Zhonghuua Wai ke Za Zhi. 1995; 33: 677-680
- Long term functional assessment after correction of tetralogy of Fallot in adulthood.Ann Thorac Surg. 2007; 83: 1790-1795
- Tetralogy of Fallot in teenagers and adults: surgical experience and follow up.Gen Thorac Cardiovasc Surg. 2007; 55: 105-112
- Tetralogy of Fallot; prognostic factors after surgical repair.Rev Port Cardiol. 2005; 24: 845-855
- Outcome after repair of tetralogy of Fallot in the first year of life.Ann Thorac Surg. 2001; 71: 494-500
- Total correction of tetralogy of Fallot in the first year of life: Late results.Ann Thorac Surg. 2002; 74: 133-138
- The result of probe technique for transatrial repair of tetralogy of Fallot.J Card Surg. 2002; 17: 490-494
- Medium term outcome for infant repair in tetralogy of Fallot: indicators for timing of surgery.Eur J Cardiothorac Surg. 2006; 30: 917-922
- Complete repair of Fallot in the neonate: results in the modern era.Ann Thorac Surg. 2000; 232: 508-514
- Elective primary repair of acyanotic tetralogy of Fallot in early infancy: overall outcome and impact on the pulmonary valve.Am Coll Cardiol. 2000; 36: 2279-2283
Article info
Publication history
Published online: April 26, 2017
Accepted:
February 17,
2017
Received in revised form:
October 31,
2016
Received:
May 4,
2016
Identification
Copyright
© 2017 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.
