Tetralogy of Fallot

Stewart, Robert D.; Mavroudis, Constantine; Backer, Carl L.

doi:10.1002/9781118320754.ch22

Cited by 2 publications

(2 citation statements)

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“…When patients with pulmonary atresia have no major collateral arteries, a patent ductus arteriosis is the only source of pulmonary blood flow. In such cases, there may be varying degrees of hypoplasia of the pulmonary arteries, but it is most often the case that all or nearly all lung segments are supplied by branches arborizing from the right and left pulmonary arteries; that is, pulmonary arborization is much more preditable 21) .…”

Section: Considerations Of the Anatomy And Pathophysiology Of Tof In mentioning

confidence: 99%

Primary repair of symptomatic neonates with tetralogy of Fallot with or without pulmonary atresia

2014

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Recently, surgical outcomes of repair of tetralogy of Fallot (TOF) have improved. For patients with TOF older than 3 months, primary repair has been advocated regardless of symptoms. However, a surgical approach to symptomatic TOF in neonates or very young infants remains elusive. Traditionally, there have been two surgical options for these patients: primary repair versus an initial aortopulmonary shunt followed by repair. Early primary repair provides several advantages, including avoidance of shunt-related complications, early relief of hypoxia, promotion of normal lung development, avoidance of ventricular hypertrophy and fibrosis, and psychological comfort to the family. Because of advances in cardiopulmonary bypass techniques and accumulated experience in neonatal cardiac surgery, primary repair in neonates with TOF has been performed with excellent early outcomes (early mortality<5%), which may be superior to the outcomes of aortopulmonary shunting. A remaining question regarding surgical options is whether shunts can preserve the pulmonary valve annulus for TOF neonates with pulmonary stenosis. Symptomatic neonates and older infants have different anatomies of right ventricular outflow tract (RVOT) obstructions, which in neonates are nearly always caused by a hypoplastic pulmonary valve annulus instead of infundibular obstruction. Therefore, a shunt is less likely to preserve the pulmonary valve annulus than is primary repair. Primary repair of TOF can be performed safely in most symptomatic neonates. Patients who have had primary repair should be closely followed up to evaluate the RVOT pathology and right ventricular function.

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Section: Considerations Of the Anatomy And Pathophysiology Of Tof In mentioning

confidence: 99%

Primary repair of symptomatic neonates with tetralogy of Fallot with or without pulmonary atresia

2014

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“…The inclusion criterion for transannular patch repair was pulmonary valve annulus hypoplasia, defined on the basis of preoperative echocardiography if the z-score was below −3. 8 The median age of the patients at the time of the surgery was 13.3 (range, 2-106) months, and the median weight was 9 (range, 3.7-19) kg. Demographic data are presented in Tables 2 and 3.…”

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confidence: 99%

Outcomes of Transannular Repair of Tetralogy of Fallot With a Contegra^® Monocuspid Patch

Wasiak

Jaworski

Pastuszko

et al. 2023

World J Pediatr Congenit Heart Surg

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Background Surgical repair of tetralogy of Fallot (ToF) depends on the anatomical variations of the heart defect. A group of patients with a hypoplastic pulmonary valve annulus required a transannular patch. This study aimed to evaluate the early and late outcomes of ToF repair with a transannular Contegra® monocuspid patch in a single center. Methods A retrospective review of medical records was conducted. This study included 224 children with a median age of 13 months who underwent ToF repair with a Contegra® transannular patch in over 20 years of observation. The primary outcomes were hospital mortality and need for early reoperations. The secondary outcomes were late death and event-free survival. Results The hospital mortality in our group was 3.1%, whereas two patients required early reoperation. Three patients were excluded from the study because follow-up data were not available. In the remaining group of patients (212 patients), the median follow-up was 116 (range, 1-206) months. One patient died because of sudden cardiac arrest at home six months after surgery. Event-free survival was observed in 181 patients (85.4%), whereas the remaining 30 patients (14.1%) required graft replacement. The median time to reoperation was 99 (range, 4-183) months. Conclusions Although surgical treatment of ToF has been performed for more than 60 years worldwide, the optimal approach in children with a hypoplastic pulmonary valve annulus remains debatable. Among options, the Contegra® monocuspid patch can be effectively used in transannular repair of ToF with good long-term results.

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Tetralogy of Fallot

Cited by 2 publications

References 133 publications

Primary repair of symptomatic neonates with tetralogy of Fallot with or without pulmonary atresia

Primary repair of symptomatic neonates with tetralogy of Fallot with or without pulmonary atresia

Outcomes of Transannular Repair of Tetralogy of Fallot With a Contegra^® Monocuspid Patch

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Tetralogy of Fallot

Cited by 2 publications

References 133 publications

Primary repair of symptomatic neonates with tetralogy of Fallot with or without pulmonary atresia

Primary repair of symptomatic neonates with tetralogy of Fallot with or without pulmonary atresia

Outcomes of Transannular Repair of Tetralogy of Fallot With a Contegra® Monocuspid Patch

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Outcomes of Transannular Repair of Tetralogy of Fallot With a Contegra^® Monocuspid Patch