Early and late results after repair of tetralogy of Fallot

Rizzoli, Giulio; Mazzucco, A; Fracasso, Alberto; Stellin, Giovanni; Rubino, Maurizio; Gallucci, Vincenzo

doi:10.1016/1010-7940(90)90045-2

Cited by 8 publications

(4 citation statements)

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“…4,6,13,[17][18][19][20] Most Finnish patients underwent a corrective operation during the follow-up, but the operative mortality rate of 9% was positively affected by shunt procedures.…”

Section: Operative Mortalitymentioning

confidence: 99%

Late Results of Pediatric Cardiac Surgery in Finland

2001

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A Population-Based Study With 96% Follow-UpHeta P. Nieminen, MD; Eero V. Jokinen, MD; Heikki I. Sairanen, MDBackground-This population-based study characterizes the history and progress of pediatric cardiac surgery in Finland.For the first time, all defects and procedures are included in an outcome study, reflecting the true effectiveness of operative treatment. Methods and Results-All data relating to the operations were collected retrospectively from hospital records. Current patient status was obtained from the population registry. Survival was evaluated with the Kaplan-Meier method applied to all patients and separately to subgroups of patients with the most common defects. The survival rates were compared with those of an age-and sex-matched general population. During the 37 years (1953 to 1989), 6461 patients underwent surgery; 96% of them were traced. The number of operations and the constellation of defects treated increased dramatically over time. Actuarial survival for the 45 years ended October 28, 1998 (the ending date of this study) was 78% for patients versus 93% for the general population. Survival and the number of operations per patient varied widely with the defect. The survival of patients with a surgically closed atrial septal defect was comparable to that of the general population, and such patients rarely needed a reoperation, whereas only 15% of patients with univentricular heart survived for 34 years, and almost all needed at least 2 operations. Conclusions-The overall survival of patients with cardiac defects corrected surgically in childhood is good compared with their estimated natural course. The increasing number of surgically treatable defects and the growing number of operations per patient reflect the increasing ability to treat more difficult cases. (Circulation. 2001;104:570-575.)

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“…4,6,13,[17][18][19][20] Most Finnish patients underwent a corrective operation during the follow-up, but the operative mortality rate of 9% was positively affected by shunt procedures.…”

Section: Operative Mortalitymentioning

confidence: 99%

Late Results of Pediatric Cardiac Surgery in Finland

2001

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“…Seventy-nine patients had class I functjonal capacity (New York Heart Association) and Fallot is unfavourable; 30% of the affected children die by the age of 6 months and 50% in their first 2 years (6,7,14). Morbidity and mortality are commonly associated with cyanotic spells, cardiac arrhythmias and right ventricular failure.…”

Section: Resultsmentioning

confidence: 99%

“…Important exceptions are when the left anterior descending artery arises from the right coronary artery or when a need for placement of a right ventricular to pulmonary artery conduit is expected, in which case a preliminary shunt procedure is generally preferred (3,6,7,9,14). patients presenting with persistent cyanosis or cyanotic spells.…”

Section: Resultsmentioning

confidence: 99%

Definitive Repair of Tetralogy of Fallot:A Review of 104 Cases

Abramov

Snir

Abramov

et al. 1995

Scandinavian Journal of Thoracic and Cardiovascular Surgery

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Definitive repair of tetralogy of Fallot was performed on 104 children, including 42 younger than 2 years (24 < 1 year and 7 < 6 months). Twenty-two had previous shunt. Transannular patching was required in 60 cases and conduit grafts in two. During 60-day postoperative observation, five patients died. Of the 99 survivors, 93 recovered without complications, three required prolonged mechanical ventilation, two reoperation and one balloon dilatation for residual left pulmonary artery stenosis. Morbidity and mortality were not significantly higher in the patients younger than 12 months, although transannular patching was more common in that age group. Previous shunt operations entailed higher prevalence of distal stenosis and distortion of the pulmonary arteries, which often necessitated surgical repair, and also considerably increased postoperative morbidity and mortality. As the outcome in definitive repair of Fallot's tetralogy is favourable, even in patients younger than 12 months, and as preliminary shunt operations are associated with heightened perioperative morbidity and mortality rates in definitive repair, we advocate the definitive operation for all young patients with severe cyanosis or cyanotic spells.

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“…Unlike a conventional transthoracic echocardiography, most TDI-derived variables are preload independent and may compliment magnetic resonance imaging by providing a noninvasive estimate of pulmonary regurgitant fraction and ventricular function. [1][2][3][4][8][9][10][28][29][30][31][32][33]…”

Section: Postoperative Peak Systolic Right-to-left Ventricular Pressure Ratio and Myocardial Histopathologymentioning

confidence: 99%

Histopathology of the right ventricular outflow tract and the relation to hemodynamics in patients with repaired tetralogy of Fallot

Chowdhury

Jha

Ray

et al. 2019

The Journal of Thoracic and Cardiovascular Surgery

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Objective: To evaluate the relationship between myocardial histopathology and tissue Doppler imaging (TDI) variables of the right ventricle and postoperative peak systolic right-to-left ventricular pressure ratio (Prv/Plv) in patients undergoing intracardiac repair for tetralogy of Fallot (TOF).Methods: Operatively resected crista supraventricularis muscle specimens from 93 patients undergoing intracardiac repair for TOF, aged 18 months to 26 years (mean, 7.02 AE 5.35 years) were subjected to light microscopy. TDI-derived parameters between the normal and abnormal categories of myocardium, the evolution of Prv/Plv, and its relationship to TDI-derived variables were tested using generalized linear random effects model using xtreg command.Results: The incidence of myocyte hypertrophy, myocytolysis, and perivascular fibrosis was 89.2%, 83.8%, and 77.4%, respectively. Although tricuspid annular peak systolic excursion, peak myocardial velocity during systole (s 0 ), and early diastolic basal lengthening of right ventricle (e 0 ) continued to improve among patients with myocardial hypertrophy, myocytolysis, and perivascular fibrosis, there was an absence of improvement of the late diastolic relaxation of right ventricular free wall (a 0 ) in patients with perivascular fibrosis. Although there was improvement of postoperative Prv/Plv in patients with myocardial fibrosis as compared with normal histology, the values were not statistically significant (b [standard error] À0.07 [0.08], P ¼ .3). Conclusions:The great majority of myocardial tissues in cyanotic TOF indicate pre-existing hypertrophic, degenerative, and fibrotic changes. Perivascular fibrosis affects the diastolic compliance of the right ventricle and may account for the absence of improvement of late diastolic relaxation (a 0 ) and greater postoperative Prv/Plv in the absence of a residual surgical lesion.

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Early and late results after repair of tetralogy of Fallot

Cited by 8 publications

References 0 publications

Late Results of Pediatric Cardiac Surgery in Finland

Late Results of Pediatric Cardiac Surgery in Finland

Definitive Repair of Tetralogy of Fallot:A Review of 104 Cases

Histopathology of the right ventricular outflow tract and the relation to hemodynamics in patients with repaired tetralogy of Fallot

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