No 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.

Background:Inflammatory reaction can produce several complications after cardiac surgery. Many attempts have been made to reduce these complications; perioperative corticosteroid therapy is one of the simplest methods.Objectives:We conducted a randomized study to evaluate the efficacy of single dose methylprednisolone, prescribed after surgery, for reducing the complications. Repair of Tetralogy of Fallot was chosen as a homogenous large group for the study.Patients and Methods:One hundred children who underwent total repair of Tetralogy of Fallot were enrolled in this study. After the surgery, all patients were transferred to pediatric ICU and were randomized (in a double-blind fashion) in 2 groups (A and B); a single dose of methylprednisolone (30 mg/kg of body weight) was injected to participants of group “A” just at the time of ICU entrance. Group “B” received no drug. Then, clinical outcomes and laboratory data were compared between the two groups.Results:The only significant differences were lower incidence of bacteremia and higher incidence of hyperglycemia in the group who were used methylprednisolone.Conclusions:Using a single postsurgical dose of methylprednisolone does not significantly alter the clinical outcome after repairing Tetralogy of Fallot.

No abstract