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发帖数: 458 | 1 J Cardiovasc Surg (Torino). 2006 Feb;47(1):65-70.
Outcome after one-stage repair of tetralogy of Fallot.
Lee C, Lee CN, Kim SC, Lim C, Chang YH, Kang CH, Jo WM, Kim WH.
Source
Department of Cardiovascular Surgery, Sejong General Hospital, Sejong Heart
Institute, Bucheon, Kyungki-do, South Korea.
Abstract
AIM:
The purpose of this study was to evaluate the outcome after one-stage repair
of tetralogy of Fallot (TOF).
METHODS:
Between May 1997 and December 2002, 240 patients with a median age of 9
months (1 month-48 years) underwent one-stage repair of TOF. Closure of
ventricular septal defect (VSD) was accomplished through the right atrium in
171 (71.3%) patients and through the right ventricle in 69 (28.7%) patients
. For the reconstruction of the right ventricular outflow tract (RVOT),
transannular repair was performed in 151 (62.9%) patients, and non-
transannular repair was performed in 89 (37.1%) patients. Follow-up was
complete, averaging 40+/-17.6 months (3 months-5.8 years).
RESULTS:
There were 2 (0.8%) operative deaths. Between early repair group (age under
6 months) and late repair group (age above 6 months), there were no
differences in the method of RVOT reconstruction (transannular vs non-
transannular) and the need for branch pulmonary artery angioplasty. Early
repair group had more transventricular VSD closure than late repair group (
46% vs 22%, P < 0.05). Duration of inotropic support and intensive care unit
(ICU) stay were longer in the early repair group (P < 0.05). Five patients
required reoperations due to RVOT obstruction (n = 3), and residual VSD (n =
2). Kaplan-Meier freedom from reoperation at 5 years was 98.3+/-1%. Nine
patients underwent catheter intervention for branch pulmonary artery
stenosis. Freedom from reintervention at 5 years was 95.4+/-1.5%. All
survivors are currently asymptomatic.
CONCLUSIONS:
One-stage repair of TOF could be performed with low mortality and morbidity.
Especially, early one-stage repair in symptomatic infant could be performed
with low risk, eliminating the need for palliative procedures.
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