Preservation of right ventricular structure and function following transatrial-transpulmonary repair of tetralogy of Fallot†

Sfyridis, Panagiotis G.; Kirvassilis, George; Papagiannis, John; Avramidis, Dimosthenis; Ieromonachos, Constantine G.; Zavaropoulos, Prodromos; Sarris, George E.

doi:10.1093/ejcts/ezs221

Cited by 24 publications

(17 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Studies report a 1-5% incidence of permanent complete AV block after TOF repair. 5,10,35 In our study, 10 patients (8.2%) developed AV block in the postoperative period, 4 of which were implanted with pacemakers due to permanent complete AV block (3.3%). In addition to these ten, 4 more received overdrive pacing for slow heart rate, making it 14 patients in total to require external pacing (11.5%).…”

Section: Mapca and Early Mortality Or Between Patients That Underwenmentioning

confidence: 63%

See 1 more Smart Citation

Factors affecting perioperative mortality in tetralogy of Fallot

Saygı

Ergül

Tola

et al. 2015

Pediatrics International

View full text Add to dashboard Cite

Poor preoperative oxygenation, presence of coronary anomaly, complete AV block in the early postoperative period, high RV pressure and requirement of ECMO appear to be the most significant factors that affect early mortality in the surgical treatment of TOF. Appropriate preoperative assessment, correct surgical strategies and attentive intensive care monitoring are required in order to reduce mortality.

show abstract

Section: Mapca and Early Mortality Or Between Patients That Underwenmentioning

confidence: 63%

“…10 The concept of early primary repair has been extended to symptomatic neonates and low operative mortality rates have been achieved. 11 Many centres favour correction in early infancy for all patients, to avoid complications of shunting and any adverse effects of more prolonged cyanosis or right ventricular hypertrophy.…”

Section: Discussionmentioning

confidence: 99%

Factors affecting perioperative mortality in tetralogy of Fallot

Saygı

Ergül

Tola

et al. 2015

Pediatrics International

View full text Add to dashboard Cite

show abstract

“…Continuous improvements in surgical techniques have made repair of tetralogy of Fallot feasible in early infancy, with low risk. 4,16,[21][22][23] Based on long-term outcomes of conventional TOF repair, many centers [9][10][11][12][13][14][15][16][17] have developed techniques designed to preserve PV function and thus limit or eliminate the long-term consequences of chronic PV regurgitation on ventricular function. 7,[24][25][26][27][28] During the past 7 years, with the aim of preserving PV function, we embarked on a new surgical approach for TOF repair that combines our standard, early, transatrial, transpulmonary TOF repair with intraoperative PV balloon dilation.…”

Section: Discussionmentioning

confidence: 99%

Preserving the pulmonary valve during early repair of tetralogy of Fallot: Anatomic substrates and surgical strategies

Vida

Angelini

Guariento

et al. 2015

The Journal of Thoracic and Cardiovascular Surgery

View full text Add to dashboard Cite

show abstract

“…Transatrial and transpulmonary repair without infundibulotomy may allow maximal preservation of the RV and pulmonary valve and this technique may be employed even in neonates for total repair [11]- [13]. The advocates of this technique suggest that the incidence of late RV dysfunction arrhythmias and reoperation for pulmonary valve replacement may be reduced [12] [13] [15] [18] [19] Avoiding infundibulotomy during repair may not allow adequate resection of hypertrophic muscular bands to relieve right ventricular outflow obstruction which may be associated with poor early outcomes due to persistent outflow tract obstruction. In the presence of existing controversies dilemma persisted for a choice of an optimal repair technique by a surgeon and the present data reflecting the both early and long term outcomes of different techniques for total repair are sparse [21].…”

Section: Discussionmentioning

confidence: 99%

Early and Long Term Outcomes of Corrective Operations for Tetralogy of Fallot: An Experience of Two Centers

Sirivella¹,

Gielchinsky²

2014

WJCS

View full text Add to dashboard Cite

Objectives: Pulmonary valve insufficiency and right ventricular dysfunction may contribute to early and late morbidity and mortality after repair of Tetralogy of Fallot. Right ventricular dysfunction may be attributed to ventriculotomy incision, especially, when it is combined with a transannular patch as employed in the transventricular repair. Transatrial/transpulmonary approach without ventriculotomy and an attempt to preserve the pulmonary valve has been advocated as a method potentially diminishing such adverse events. The prevalence of associated morbidity and mortality and analysis of the results of various surgical approaches for repair of Tetralogy of Fallot formed the basis of this study. Methods: Nine hundred and ninety five patients during 20 yearS period (from 1992 and 2012) with primary diagnosis of Tetralogy of Fallot that underwent total repair operations in two medical centers were analyzed. The mean age of the patients was 2.9 ± 6.9 SE, with female/male ratio of 0.25. The mean long follow-up was 94 months ± 112 SD. Results: Repair via ventriculotomy with transannular patch was the most common technique (n = 627, 63%), followed by infundibulotomy without transannular patch (20%) and transatrial/transpulmonary approach without ventriculotomy (15%). The operative and long term mortality were 3.2% and 4.4%; 2% and 3.1%; 2% and 2.7% respectively. The overall operative and long term mortality for repairs was 2.9% and 3.4%, with high 3.94% and 6.6% respectively for repairs with right ventricular pulmonary valve conduit. There was statistically significant correlation between the type of repair and mortality risk. Use of transannular patch with ventriculotomy was associated with significant increase in overall mortality risk and operative mortality compared with ventriculotomy without transannular patch. [Odds ratio, 2.10; 95% confidence interval: 1.29 -3.64]. Operations that have been performed before 2000 have resulted in increased operative risk compared with those performed after 2000. [Odds ratio 1.45; 95% confidence interval: 1.03 -2.01]. Conclusions: Overall mortality for Tetralogy of Fallot repair was low. The repair by ventriculotomy with transannular patch was the most common technique and was associ-S. Sirivella, I. Gielchinsky 187 ated with higher mortality. Repairs through infundibulotomy without transannular patch and repair without ventriculotomy were less common, but were associated with lower mortality. Current advances in management, anatomical substrate of the lesion, choice of a repair and surgical expertise may all determine the mortality risk.

show abstract

Preservation of right ventricular structure and function following transatrial-transpulmonary repair of tetralogy of Fallot†

Cited by 24 publications

References 15 publications

Factors affecting perioperative mortality in tetralogy of Fallot

Factors affecting perioperative mortality in tetralogy of Fallot

Preserving the pulmonary valve during early repair of tetralogy of Fallot: Anatomic substrates and surgical strategies

Early and Long Term Outcomes of Corrective Operations for Tetralogy of Fallot: An Experience of Two Centers

Contact Info

Product

Resources

About