Outcomes of Total Surgical Correction for Tetralogy of Fallot in Benghazi

Abstract

Tetrology of Fallot (TOF) is the most common cyanotic congenital heart disease, accounting for 10% of all types of congenital heart disease. Despite decreased mortality rates by improvement in surgery and post-cardiac intensive care, there continues to be late postoperative complications. This study aimed to evaluate the outcomes after total repair of tetralogy of Fallot, including 44 children who underwent complete surgical repair between 2000 to 2018. Data were collected from medical records and directly from patients during their visit to the clinic, that included: history, clinical examination, gender, age at operation, results of ECG, Holter monitoring, echocardiography, cardiac catheterization, cardiac CT scan. Follow-up ranged from 6 months to18 years. Results revealed that the M/F ratio was 1.4:1. Also, two patients had a previous palliative systemic artery to PA shunt. A TAP was inserted in 22 (50%) patients. Postoperative complications were: severe PR 29%, small residual VSD 18.1%, and two patients had significant VSD which needed surgical intervention, residual RVOT 8.1%, RBBB 97.7%, There was three death (6.8%), and 36.3% of patients will need surgical intervention in the future. It was concluded that follow-ups up to adulthood to monitor potential complications are necessary. QRS duration is used for monitoring ventricular arrhythmia and sudden death. Echocardiography is a non-invasive tool in diagnosis, before and at the time of surgery, as well as in follow-ups.