Surgical treatment of adult tetralogy of Fallot in 227 patients

Abstract

Objective To summarize the experience and early outcomes of surgical treatment of adult tetralogy of Fallot(ATOF). Methods We retrospectively analyzed the clinical data of 227 patients with ATOF who underwent surgical repair in the Department of Cadiovascular Surgery, Guangdong Cardivascular Institute from January 2004 to December 2014. There were 112 males and 115 females at a median age of 34 years(range, 18 to 58 years) and a mean weight of(49.00±8.27) kg. All patients were underwent one stage repair, including 129 cases with transannular patch and 61 cases with MAPCAs in which 4 cases were underwent hybrid occlusion. Results There were 12 cases died in hospital(5.3%), 24 cases with Re-thoratomy for hemaostsis, 5 cases with poor wound healing, 10 cases with postoperative pneumonia. There were 25 cases with residual VSD including 8 cases caused by surgeon in congenital heart disease department and 17 cases caused by surgeon in adult heart disease department(P<0.05). The repair with transannular patch required significantly longer bypass time[(87.83±26.02) min vs.(78.47±26.00) min, P=0.009]. The cases with MAPCAs had higher cost than that with no MAPCAs[(83 137.01±69 363.05) RMB vs.(66 184.29±44 219.38) RMB, P=0.03]. Conclusion The early outcomes of ATOF is good. The cases with MAPCAs had higher cost than that with no MAPCAs. The CHD surgeon had lower probability of residual VSD. Preoperative evaluation of MAPCAs by CHD surgeon and perioperative maintain of the right ventricular function were helpful. Key words: Tetralogy of Fallot; Complications; Cardiac surgical procedures