Early outcome of total correction in adult tetralogy of fallot patients.

  • Zaigham Rasool Khalid Faisalabad Institute of Cardiology Faisalabad.
  • Abdul Razzaq Mughal Faisalabad Institute of Cardiology Faisalabad.
  • Muhamamd Mujtaba Ali Siddiqui Rawalpindi Institute of Cardiology, Rawalpindi.
  • Riaz ul Haq Faisalabad Institute of Cardiology Faisalabad.
Keywords: Low Cardiac Output, Pericardial Patch, Stroke, Tetralogy of Fallot, Tamponade

Abstract

Objectives: To detect the early outcome of total correction of Tetralogy of Fallot (TOF) in adult patients of age 16 years or above. Study Design: Retrospective descriptive case series. Setting: Paediatric Cardiac Surgery Department of Faisalabad Institute of Cardiology, Faisalabad. Period: October 2016 to June 2019. Material & Methods: All consecutive patients of age 16 years or above who underwent total correction for TOF during study period were included. Surgical procedure and early outcome measures were recorded and analyzed. Results: Sixty nine patients underwent total correction for TOF during the study period. Majority of patients (n=55, 79.7%) were between16 to 25years of age. Male dominated the study population (56.5%, n=39) with male to female ratio 1.3: 1. Nine patients (13%) had coiling of MAPCA before surgery while prior palliation with Blalock Taussig shunt (BT Shunt) was seen in 5.8 % patients (n=4). All patients were operated with trans-atrial trans-pulmonary approach (n=69, 100%). Pulmonary artery was augmented with pericardial patch in 22 cases (32%) while left pulmonary artery (LPA) augmentation was done in two patients. Pulmonary valve annulus divided in 22 % of patients (n=15), RVOT was reconstructed with trans-annular pericardial patch in 10.1% patients (n=7) while Pulmonary valve was replaced with tissue valve in 7 patients (10.1%). In one patient RV to PA continuity was established with contegra. Post operatively Inotropic support was given for initial 39 ±45 hours, mean ICU stay was 39±75 hours, mean chest drainage 1086±741 ml and mean requirement for blood transfusion was 2.2 ±2.4 units. As regard early complications, six patients had tiny to small residual VSD (8.7%) while no patient developed complete heart block. Two patients had neurological damage (2.9%), one patient developed renal failure (1.45%) while chest reopening was done in two patients due to postoperative bleeding and/ or tamponade (2.9%). There was death of two patients (2.9%), one had renal failure due to low cardiac output (LCOS) and the other had stroke. Conclusion: The early outcome of complete repair of TOF in patients 16 years and above is good with a negligible mortality and limited number of complications.

Author Biographies

Zaigham Rasool Khalid, Faisalabad Institute of Cardiology Faisalabad.

MBBS, FCPS (Surgery), FCPS (Cardiac Surgery)

Assistant Professor Paediatric Cardiac Surgery

 

Abdul Razzaq Mughal, Faisalabad Institute of Cardiology Faisalabad.

MBBS, FCPS (Paediatric Medicine),

FCPS (Paediatric Cardiology)

Assistant Professor Paediatric Cardiology

Muhamamd Mujtaba Ali Siddiqui, Rawalpindi Institute of Cardiology, Rawalpindi.

MBBS, FCPS (Surgery), FCPS (Cardiac Surgery)

Associate Professor Cardiac Surgery

Riaz ul Haq, Faisalabad Institute of Cardiology Faisalabad.

MBBS

Postgraduate Resident MS Cardiac Surgery

Published
2020-06-10