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Early definitive repair of tetralogy of Fallot: a review of 74 cases

Published online by Cambridge University Press:  19 August 2008

Dan Abramov ,
Jacob Barak ,
Ehud Raanani ,
Einat Birk  and
Bernardo A. Vidne
Dan Abramov
Affiliation:
Department of Pediatric Cardiology, Rabin Medical Center, Beilinson Campus, affiliated to the Sackler Faculty of Medical Sciences, Tel Aviv University, Israel
Jacob Barak
Affiliation:
Department of Pediatric Cardiology, Rabin Medical Center, Beilinson Campus, affiliated to the Sackler Faculty of Medical Sciences, Tel Aviv University, Israel
Ehud Raanani
Affiliation:
Department of Pediatric Cardiology, Rabin Medical Center, Beilinson Campus, affiliated to the Sackler Faculty of Medical Sciences, Tel Aviv University, Israel
Einat Birk
Affiliation:
Department of Cardiothoracic Surgery, Rabin Medical Center, Beilinson Campus, affiliated to the Sackler Faculty of Medical Sciences, Tel Aviv University, Israel
Bernardo A. Vidne*
Affiliation:
Department of Pediatric Cardiology, Rabin Medical Center, Beilinson Campus, affiliated to the Sackler Faculty of Medical Sciences, Tel Aviv University, Israel
*
Prof. B A. Vidne, Head of Cardiothoracic Surgery, Rabin Medical Center, Petach Tikva 49100, Israel. Tel +972-3-9376701. Fax: +972-3-9240762
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Abstract

Definitive repair of tetralogy of Fallot was performed on 74 patients under two years of age, including 40 under the age of one year and 13 less than 6 months of age. In six patients, there had been previous construction of a systemic-to-pulmonary arterial shunt. Patching across the ventriculo-pulmonary junction was required in 46 patients, placement of conduits in six, and procedures producing unifocaliza-tion in three. Three patients died during the 60-day postoperative period of observation. Of the 71 survivors, 64 recovered without complications. One patient had neurologic sequels, one required prolonged mechanical ventilation, two reoperation, and one balloon dilation of residual left pulmonary arterial stenosis. Morbidity and mortality were not significantly higher in those patients undergoing surgery at earlier than 6 months of age, although transjunctional patching was more common in that age group. Previous construction of a shunt was associated with a higher prevalence of distal stenosis and distortion of the pulmonary arteries, which needed surgical repair in two out of six patients (33%). Since the outcome of definitive repair is favourable in patients with tetralogy of Fallot younger than six months of age, we now advocate definitive surgery for all young symptomatic patients by the age of six months.

Keywords

Tetralogy of Fallotsurgery in congenital heart diseasesurgery in infants
Type
Original Articles
Information
Cardiology in the Young , Volume 7 , Issue 3 , July 1997 , pp. 254 - 257
Copyright
Copyright © Cambridge University Press 1997

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References

1.Hornereffer, PJ, Zahka, KG, Rowe, SA. Long term results of total repair of tetralogy of Fallot in childhood. Ann Thorac Surg 1990;50:179–185.CrossRefGoogle Scholar
2.Ilbawi, MN, Idriss, FS, De-Leon, SY. Factors that exaggerate the deleterious effects of pulmonary insufficiency on the right ventricle after tetralogy repair. J Thorac Cardiovasc Surg 1987;93:36–44.CrossRefGoogle ScholarPubMed
3.Rizzoli, G, Mazzucco, A, Fracasso, A. Early and late results after repair of tetralogy of Fallot. Eur J Cardiothorac Surg 1990;4:371–378.CrossRefGoogle ScholarPubMed
4.Kirklin, JW, Blackstone, EH, Pacifico, AD. Routine primary repair vs two stage repair of tetralogy of Fallot. Circulation 1979;60:373–380.CrossRefGoogle ScholarPubMed
5.Vobecky, SJ, Williams, WG, Freedom, RM. Survival analysis of infant under age of 18 months presenting with tetralogy of Fallot. Ann Thorac Surg 1993;56:944–950.CrossRefGoogle ScholarPubMed
6.Groh, MA, Melinois, JN, Bove, EL. Repair of tetralogy of Fallot in infancy. Circulation 1991;84(suppl 3):206–212.Google ScholarPubMed
7.Di Donate, RM, Jones, RA, Lang, P.Neonatal repair of tetralogy of Fallot with and without pulmonary atresia. J Thorac Cardiovasc Surg 1991;101:126–137.CrossRefGoogle Scholar
8.Joffee, H, Georgakopoulos, D, Deanfield, JE. Late ventricular arrhythmia is rare after early repair of tetralogy of Fallot. J Am Coll Cardiol 1994;23:1146–1150.CrossRefGoogle Scholar
9.Geva, T, Ayres, NA, Pac, FA, Pignatelli, R. Quantitative morphometric analysis of progressive infundibular obstruction in tetralogy of Fallot. Circulation 1995;92(4): 886–892.CrossRefGoogle ScholarPubMed
10.Seliem, MA, Wu, YT, Glenwright, K. Relation between age at surgery and regression of right ventricular hypertrophy in tetralogy of Fallot. Pediat Cardiol 1995;16(2):53–55.CrossRefGoogle ScholarPubMed
11.Abramov, D, Snir, E, Vidne, BA. Definitive repair of tetralogy of Fallot: A review of 104 cases. Scand J Thorac Cardiovasc Surg 1996;29:Google Scholar
12.Mishaly, D, Birk, E, Elami, A, Vidne, BA. Autologous monocusp pulmonary valve: Preliminary results. Ann Thorac Surg 1996; 61: 1811–1815.CrossRefGoogle ScholarPubMed
13.Murphy, JG, Gersh, BJ, Danielson, GK. Long term outcome in patients undergoing surgical repair of tetralogy of Fallot. N Engl J Med 1993; 329: 593–599.CrossRefGoogle ScholarPubMed
14.Jonsson, H, Ivert, T, Bjork, VO. Work capacity and central hemodynamics thirteen to twenty-six years after repair of tetralogy of Fallot. J Thorac Cardiovasc Surg 1995; 110: 416–426.CrossRefGoogle ScholarPubMed
15.Sousa-Uva, M, Chardigny, C, Planche, C. Surgery for tetralogy of Fallot at less than six months of age. Eur J Cardiothorac Surg 1995;9:453–460.CrossRefGoogle ScholarPubMed
16.Hennein, HA, Mosca, RS, Bove, EC. Intermediate results after complete repair of tetralogy of Fallot in neonates. J Thorac Cardiovasc Surg 1995;109(2):332–342.CrossRefGoogle ScholarPubMed