Long-Term Outcome of the Right Ventricular Outflow Tract Palliation Procedure in Children With Cyanotic Congenital Heart Disease: A Case-Series Study

Abstract

Background: The right ventricular outflow tract (RVOT) palliation has been shown to be a proper interventional procedure for lowering risk of mortality and improving clinical condition in cyanotic congenital heart disease (CHD) patients. Objectives: The present study aimed to assess the consequences of RVOT palliation in patients with TOF. Patients and Methods: This prospective case series was performed on 17 children who suffered from cyanotic CHD. The study endpoints were assessed by pulse oximetry, echocardiography, and electrocardiography immediately and also 12 months after RVOT palliation procedure. Results: The mean age of patients was 24.76 (median 10 months). Comparing laboratory and respiratory parameters 12 months after RVOT palliation showed a significant increase in arterial oxygen saturation (from 69.34 ± 13.07 to 86.29 ± 6.64, P = 0.001), RPA index of right pulmonary artery (from 5.49 ± 1.67 mm to 7.59 ± 1.79 mm, P < 0.001), Z score of right pulmonary artery (from -1.56 ± 2.34 to 0.53 ± 2.55, P < 0.001), LPA of left pulmonary artery (from 5.64 ± 1.88 mm to 8.06 ± 2.72 mm, P < 0.001), and also in Z score of left pulmonary artery (from -1.56 ± 2.33 to 0.78 ± 2.15, P = 0.001). Also, a significant decrease in the spell rate (from 88.2% to 17.6%, P < 0.001), and in the rate of tricuspid regurgitation (from 23.5% to 11.8%, P = 0.023) was shown. Cardiac arrhythmia occurred in only one patient that was transient. Stent fracture was found in none of the patients. Stent stenosis was also found in one patient. One-year death occurred only in one child. Conclusions: The right ventricular outflow tract palliation in children with cyanotic CHD leads to long-term favorable outcome regarding improvement in oxygen saturation, increase in Z score of both left and right pulmonary arteries and also considerable decrease in spell. Also, death and complications are rare following RVOT palliation.