| Title |
Radikali Fallot tetrados korekcija vaikams iki trijų metų / |
| Translation of Title |
Complete repair of tetralogy of Fallot in the first three years of life. |
| Authors |
Karalius, Rimantas ; Nogienė, Giedrė ; Žilinskas, Vidmantas-Jonas ; Sudikienė, Rita ; Lebetkevičius, Virgilijus ; Tarutis, Virgilijus ; Liekienė, Daina ; Sirvydis, Vytautas-Jonas |
| DOI |
10.15388/LietChirur.2007.3.2212 |
| Full Text |
|
| Is Part of |
Lietuvos chirurgija. 2007, t. 5, Nr. 3, p. 386-391.. ISSN 1392-0995 |
| Keywords [eng] |
tetralogy of Fallot ; radical correction ; infants |
| Abstract [eng] |
Background / objective: Complete corrections of tetralogy of Fallot (TOF) have been frequently performed for infants and even newborns in the last decade. The discussion vvhether early correction of tetralogy of Fallot influences the survival and the frequency of re-operation due to residual right ventricle outflow tract (RVOT) or pulmonary artery insufficiency rate is still going on. The aim of the present work was to evaluate the early and late results of radical corrections in children less than 3 years of age, performed at Vilnius University Heart Surgery Centre. Patients and methods: During two 5-year periods (1996-2000, 2001-2005) 23 infants underwent repair for TOF. The mean age of the patients during the first period was 25.9 ± 2.8 months and during the second period 16.8 ± 2.9 months. During both periods 10 (43.5%) and 18 (78.3%) primary radical corrections of TOF were performed. A transannular patch was inserted in 22 patients (95.6%) during the first 5-year period: 8 patients underwnt transannulorplasty only, and for 14 patients transannulorplasty using a monocusp patch was performed. During the period 2001 through 2005, only 4 patients underwent RVOTplasty by means of monocusp patch. Results: Two patients (8.7%) died within 30 days postoperatively during the first 5-year period and there were two late deaths. There was one death (4.3%) during the second period. The patients underwent echocardiography evaluation, measurements of pulmonary artery insufficiency and RVOT obstruction grade at late postoperative periods. Pulmonary artery insufficiency grade 2-3 and 3 was revealed in 8 (42.1%) patients operated on during the first 5-year period. For four of them, transannular monocusp patch was used for RVOTplasty. Two patients showed a RVOT gradient higher than 40 mm Hg. For three patients (13.6%) operated on during the second 5-year period, pulmonary insufficiency grade 2-3 and 3 was diagnosed, and a RVOT gradient higher than 40 mHg was found in six patients. Re-operation was required for four patients of the first 5-year period: three patients needed to be operated on because of a marked pulmonary artery insufficiency and one for re-canalization of a ventricle septum defect. Conclusions: Radical correction of tetralogy of Fallot may be safely performed in younger patients. Therefore, the number of primary radical correction of this malformation is increasing. The use of transannular patch increases the risk of re-operations due to pulmonary artery insufficiency. The use of transannular monocusp patch does not prevent pulmonary artery valve insufficiency at a late postoperative period. |
| Type |
Journal article |
| Language |
Lithuanian |
| Publication date |
2007 |
| CC license |
|
