Outcome of Management of Tetralogy of Fallot in a Cardiac Center of a Tertiary Care Hospital in Bangladesh

Abstract

Background: Congenital heart diseases (CHD) represent one of the major groups of birth defects and make up approximately 1% of human malformations. Incidence of congenital heart disease is 8-10/1000 live births. The incidence is higher in premature infants. In Bangladesh incidence of congenital heart diseases was found up to 25/1000 live birth in a one year study conducted in CMH Dhaka. Congenital cyanotic heart disease accounts for less than 25% of total congenital cardiac defects. In TOF the lungs are under-perfused as blood shunts from right to left bypassing the lungs. TOF constitutes 5-7% of congenital heart disease. It is the commonest congenital cyanotic heart disease in Bangladesh. Objective: The aim of this study was to assess outcome of management of Tetralogy of Fallot in a cardiac center of a tertiary care hospital in Bangladesh. Methodology: It was a retrospective observational study and was conducted in the department of Pediatric Cardiology of Combined Military Hospital (CMH), Dhaka, Bangladesh from January 2015 to December 2016. We included 50 patients with TOF taking treatment from our department. All the patients were divided into three groups according to treatment type. Medical management group, palliative surgery group and total intra cardiac repair group and their outcome were assessed. Results: In our study we found 6 (12%) patients were in medical management group, 8 (16%) were in palliative surgery group and 36 (72%) were in total intra cardiac repair group. Among them 33 (66%) were male and 17 (34%) were female. Majority patients 30 (60%) were in less than 3 years of age. In medical management group all the patients had oxygen saturation <80%, 4 (66.68%) patients reduced frequency of hyper-cyanotic spell, 1 (16.67%) patient had cerebral abscess. In palliative surgery group 6 (75%) patients had >90% oxygen saturation, 2 (25%) had <90% oxygen saturation, tet spell reduced in all the cases. After total intra cardiac repair no patient had .....