Correction Of Tetralogy Research Articles

Predictors of mortality in total correction of tetralogy of fallot

Predictors of mortality in total correction of tetralogy of fallot

783 Systolic and diastolic function of left ventricle and pulmonary insufficiency in adult patients after total correction of tetralogy of Fallot

783 Systolic and diastolic function of left ventricle and pulmonary insufficiency in adult patients after total correction of tetralogy of Fallot

Endogenously acquired deep sternal wound infection after congenital cardiac surgery

A 10-month-old child from the Middle East received complete correction for tetralogy of Fallot. Despite an initially uneventful postoperative course, he developed severe deep sternal wound infection after 7 days. This complication was endogenously acquired caused by a resistant and rarely present in Europe, Streptococcus pneumonia. Following surgical debridement, betadine rinsing for 3 days and with a course of specific antibiotic therapy, the patient was discharged in good health.

Surgical correction of tetralogy of fallot in adults in the current era

Surgical correction of tetralogy of fallot in adults in the current era

Repair of Pulmonary Regurgitation Following Surgical Correction of Tetralogy of Fallot

Repair of Pulmonary Regurgitation Following Surgical Correction of Tetralogy of Fallot

Influence of Perioperative Factors on Outcome in Children <18 Months of Age After Surgical Correction of Tetralogy of Fallot

Influence of Perioperative Factors on Outcome in Children <18 Months of Age After Surgical Correction of Tetralogy of Fallot

Very Long Term Follow-up (22-42 Years) After Correction of Tetralogy of Fallot: Transient Complete Heart Block Is Associated With Increased Risk of Sudden Death

Very Long Term Follow-up (22-42 Years) After Correction of Tetralogy of Fallot: Transient Complete Heart Block Is Associated With Increased Risk of Sudden Death

Very long term follow-up (22–42 years) after correction of tetralogy of Fallot: transient complete heart block is associated with increased risk of sudden death

Very long term follow-up (22–42 years) after correction of tetralogy of Fallot: transient complete heart block is associated with increased risk of sudden death

Long-Term Followup following Surgical Correction of Tetralogy of Fallot

Long-Term Followup following Surgical Correction of Tetralogy of Fallot

Surgical experience with total correction of tetralogy of Fallot in infancy

Surgical experience with total correction of tetralogy of Fallot in infancy

The long-term influence of pulmonary valve regurgitation following repair of tetralogy of Fallot: does preservation of the pulmonary valve ring affect quality of life?

The transannular patch (TAP) repair used in the correction of tetralogy of Fallot (TOF) inevitably causes pulmonary regurgitation. We report herein the results of a long-term follow-up study conducted on 50 patients who had undergone a TAP repair 20-29 years earlier to evaluate the influence of pulmonary regurgitation on their late outcome and quality of life. As a control, 26 patients with an intact pulmonary valve ring and right ventricular outflow patch (RVP) confined to the subvalvular region were also studied. The 25-year survival rates of the TAP and RVP groups were 88.5% and 95.7%, respectively, and the event-free rates at 25 years were 73.3% and 90.9%, respectively. Although the absolute values of these rates were higher in the RVP group, there were no statistically significant differences between the two groups. To assess quality of life, the occupational status, childbearing ability, and late symptoms were evaluated, and found to be comparable between the two groups. Moreover, a treadmill submaximal stress test did not show any differences in exercise capacity between the two groups. In conclusion, the presence of a TAP does not significantly alter the late results or quality of life of patients who have undergone repair of TOF.

Assessment of risk factors for early mortality after total correction of Tetralogy of Fallot

Assessment of risk factors for early mortality after total correction of Tetralogy of Fallot

Clinical value of aortic thermodilution monitoring of cardiac output in a small child after surgical correction of tetralogy of fallot

Clinical value of aortic thermodilution monitoring of cardiac output in a small child after surgical correction of tetralogy of fallot

Technique for constructing the pulmonary trunk for tetralogy of fallot with pulmonary atresia

In expectation of the growth of a new pulmonary arterial trunk in total correction of tetralogy of Fallot with pulmonary atresia, we used pedicled autologous pericardium combined with left atrial appendage as the posterior wall of a new pulmonary arterial trunk. In cases of long discontinuity between the right ventricular infundibulum and left pulmonary artery, our technique could be recommended for early repair of tetralogy of Fallot with pulmonary atresia.

Clinical characteristics of patients over 20 years old without total correction in tetralogy of Fallot

Clinical characteristics of patients over 20 years old without total correction in tetralogy of Fallot

Repeated repair of tetralogy of Fallot. Report of 11 cases and review of the literature.

Eleven patients underwent late repeated correction of tetralogy of Fallot in 1991-1993. The previous operation was repair of simple Fallot's tetralogy in seven cases, repair plus transannular patch in one case and repair of tetralogy and pulmonic atresia in three cases. The indications for reoperation were residual ventricular septal defect, right ventricular outflow tract (R.V.O.T.) obstraction, residual branch pulmonary artery stenosis, aneurysmal dilatation of R.V.O.T. Patch or combination of any of the above. At reoperation these defects were corrected. The post operative course was uneventful in eight patients. Two required mechanical ventilation for 2-3 days, and one underwent another operation for residual branch pulmonary artery stenosis. The functional and haemodynamic results were good in ten patients, and one had residual distal pulmonary artery stenosis. There were no death during 2 years of follow-up. Repeated correction of tetralogy of Fallot thus had low postoperative morbidity and good haemodynamic results. For the relatively few patients initially found to have tetralogy of Fallot and pulmonic atresia, the outcome may be less favorable.

Total correction of tetralogy of Fallot without “routine”preoperative cardiac catheterization—management of 99 patients

SummaryBetween January 1989 and March 1993, total correction was performed in 99 patients with tetralogy of Fallot without submitting them to prior cardiac catheterization. The age of the patients ranged from 1.33 to 18 years (mean 5.33±3.77). After complete echocardiographic examination, the diameters of the right and left pulmonary arteries at the prebranching point and the descending thoracic aorta at the diaphragm were measured by cross-sectional echocardiography and the McGoon ratio was calculated. Total correction was performed in all patients with a McGoon ratio greater than 1.7. In none of the patients were the sizes of the pulmonary artery measured by echocardiography smaller than the measurements obtained during surgery. Transannular patching was performed in 76 patients. A conduit from the right ventricle to the pulmonary arteries was constructed in two patients with coronary arterial anomalies. Postrepair right ventricular to left ventricular systolic pressure ratios were between 0.25 and 0.85 (mean 0.54±0.13). There were two hospital deaths, neither being related to the diagnostic method used nor the criteria for surgery. We conclude that the diagnosis of tetralogy of Fallot together with measurements of pulmonary arteries and descending thoracic aorta can safely and reliably be achieved echocardiographically. The McGoon ratio can be adapted to echocardiography and total correction can be performed successfully based on echocardiographic examination.

Reoperation for residual defects following intracardiac repair for tetralogy of Fallot

Reoperation was carried out in two patients who had previously undergone correction for tetralogy of Fallot and presented with severe pulmonary hypertension. One patient who had undergone intracardiac repair five years earlier had a residual ventricular septal defect (VSD), right ventricular outflow (RVOT) obstruction, patent ductus arteriosus and severe pulmonary hypertension. The second patient, who had undergone intracardiac repair four years earlier, also had a residual VSD and RVOT obstruction. Both underwent VSD closure, RVOT resection and pulmonary valve replacement and did well postoperatively. We recommend aggressive surgical treatment in such patients even in the presence of pulmonary hypertension.

Life-threatening arterial haemorrhage: Results of treatment by transcatheter embolization using home-made steel coils

Major arterial haemorrhage can be fatal. Its management by percutaneous embolization using commercially available embolizing agents is well established. We describe the use of home-made steel coils in the treatment of five patients. These coils were designed during the procedure in order to conform to the dimension of the bleeding artery. The group included two patients with life-threatening haemoptysis after surgical correction for tetralogy of Fallot; one patient each with exsanguinating haemorrhage from a branch of the left profunda femoral artery following violent trauma; massive haematuria due to an inoperable hypernephroma; and haemoptysis due to post-tubercular bronchiectasis. The bleeding vessel was evaluated by selective angiography in each patient. After assessing its length and diameter, steel coils of desired dimensions were made by utilizing a conventional 0.032-in wide guidewire and these were released into the bleeding artery. Occlusion of the bleeding vessel was obtained in all patients, without complication. Fabrication of coils of desired length and diameter can be done within a few minutes during the procedure. These coils provide an effective method of treating life-threatening arterial haemorrhage in selected cases.

Determinants of short- and long-term outcome in the surgical correction of tetralogy of Fallot.

Although biventricular correction of tetralogy of Fallot has been with us for well over three decades, the optimal treatment of these patients continues to be debated, and surgical techniques refined. There can be no doubt that operative mortality has improved, and no matter which approach is chosen, an early mortality of less than 5% should be easily achievable. As with most other areas of pediatric cardiology and cardiac surgery, these admirable early results are truly only the beginning. While reflecting the results of surgery in an earlier era, some of the long-term follow-up data beginning to emerge from studies of these patients, particularly in regard to the effect of pulmonary incompetence, is compelling and must be taken into account when deciding the optimal surgical treatment for the individual child presenting today with tetralogy of Fallot. This article reviews some of the more recent data regarding the functional outcome of these patients as well as the surgical approaches that have been developed to address them.