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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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