A 26-year experience with surgical management of tetralogy of fallot: risk analysis for mortality or late reintervention

Knott‐Craig, Christopher J.; Elkins, Ronald C.; Lane, Mary M.; Holz, Jeannie; McCue, Carolyn M.; Ward, Kent E.

doi:10.1016/s0003-4975(98)00493-7

Cited by 109 publications

(71 citation statements)

References 29 publications

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“…Surgical outcomes compare favourably with the developed world; (2,18) however there is a much earlier detection of patients mainly in the antenatal period in the first world countries.…”

Section: Consequently Many Children With Chd Living In Poorly Resourcedmentioning

confidence: 94%

An audit of surgical repair of Tetralogy of Fallot in an African tertiary care centre

Ngwezi

Vanderdonck

Levin

et al. 2017

SAHJ

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“…Surgical outcomes compare favourably with the developed world; (2,18) however there is a much earlier detection of patients mainly in the antenatal period in the first world countries.…”

Section: Consequently Many Children With Chd Living In Poorly Resourcedmentioning

confidence: 94%

An audit of surgical repair of Tetralogy of Fallot in an African tertiary care centre

Ngwezi

Vanderdonck

Levin

et al. 2017

SAHJ

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“…4,6,13,[17][18][19][20] Most Finnish patients underwent a corrective operation during the follow-up, but the operative mortality rate of 9% was positively affected by shunt procedures.…”

Section: Operative Mortalitymentioning

confidence: 99%

“…The 15-year natural survival rate is 14%, whereas after successful corrective surgery, it exceeds 90%. 6,[17][18][19] In our material, which also included patients with only palliation, the actuarial survival rates for 15 years were 82% and 90% after operative mortality was excluded.…”

Section: Late Survivalmentioning

confidence: 99%

Late Results of Pediatric Cardiac Surgery in Finland

2001

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A Population-Based Study With 96% Follow-UpHeta P. Nieminen, MD; Eero V. Jokinen, MD; Heikki I. Sairanen, MDBackground-This population-based study characterizes the history and progress of pediatric cardiac surgery in Finland.For the first time, all defects and procedures are included in an outcome study, reflecting the true effectiveness of operative treatment. Methods and Results-All data relating to the operations were collected retrospectively from hospital records. Current patient status was obtained from the population registry. Survival was evaluated with the Kaplan-Meier method applied to all patients and separately to subgroups of patients with the most common defects. The survival rates were compared with those of an age-and sex-matched general population. During the 37 years (1953 to 1989), 6461 patients underwent surgery; 96% of them were traced. The number of operations and the constellation of defects treated increased dramatically over time. Actuarial survival for the 45 years ended October 28, 1998 (the ending date of this study) was 78% for patients versus 93% for the general population. Survival and the number of operations per patient varied widely with the defect. The survival of patients with a surgically closed atrial septal defect was comparable to that of the general population, and such patients rarely needed a reoperation, whereas only 15% of patients with univentricular heart survived for 34 years, and almost all needed at least 2 operations. Conclusions-The overall survival of patients with cardiac defects corrected surgically in childhood is good compared with their estimated natural course. The increasing number of surgically treatable defects and the growing number of operations per patient reflect the increasing ability to treat more difficult cases. (Circulation. 2001;104:570-575.)

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“…Transanüler yama kullanılmayan hastalarda uzun dönemde rezidüel çıkım yolu darlığı gelişebilece-ği gibi, geniş yama kullanılan hastalarda pulmoner yetmezlik gö-rülme olasılığı artmaktadır. Bu komplikasyonlar genellikle erken dönemde iyi tolere edilmekle birlikte, bazı hastalarda ameliyat tekrarı gerekebilir (3) . Hastamızda, rezidüel çıkım yolu darlığının tam düzeltme ameliyatında RVOT'yi çaprazladığı düşünülen koroner arter nedeniyle sağ ventrikülotominin sınırlı tutulmasına, yapılan kas rezeksiyonunun yetersiz olmasına ve insizyonun primer olarak kapatılmasına bağlı olduğunu düşündük.…”

Section: Discussionunclassified

Residual Obstruction Detected During Pregnancy 28 Years After Total Correction of Tetralogy of Fallot and Its Surgical Treatment

Taşar¹

2015

Kosuyolu Heart Journal

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GİRİŞİlk olarak 1888 yılında tanımlanan Fallot tetralojisinin dört bileşeni ventriküler septal defekt (VSD), sağ ventrikül çıkım yolu darlığı (RVOT), aort dekstropozisyonu ve sağ ventrikül hipertrofi sidir. İlk cerrahi yaklaşım 1945 yılında Blalock tarafından gerçekleştirilen şant operasyonu olmakla birlikte, yıllar içinde çeşitli sistemik-pulmoner şant yaklaşımları kullanılmıştır. 1954'te Lillehei tarafından kontrollü kros sirkülasyon kullanılarak ilk başarılı tam düzeltme ameliyatı gerçekleştirilmiştir.Fallot tetralojili çoğu hasta doğumda tedavi gerektirmez. Sistemik arteryel oksijen satürasyonunda ilerleyici bir düşüş gelişir ve %75-80'nin altına indiğinde girişim gerekebilir. Bu hastalarda tipik olarak görülen hipoksik spell varlığı da bir ameliyat endikasyonu olarak kabul edilmektedir. Çoğu merkezde Fallot tetralojisi elektif olarak 6 ay-1 yaş aralığında tedavi edilmektedir.Tam düzeltme ameliyatı yaygın olarak kabul görmüş olmasına rağmen, bazı özel durumlarda (pulmoner vasküler yatağın iyi gelişmediği durumlar) başlangıçta palyatif amaçlı şant uygulanması gerekebilmektedir. Tam düzeltme ameliyatı ile daha iyi büyüme ve organ gelişimi, hipoksemiye daha az maruz kalma, daha iyi sol ventrikül fonksiyonları ve daha az disritmi oranları elde edilebilmektedir (1) . ÖZETFallot tetralojisi (TOF) tüm siyanotik kalp hastalıkları arasında en sık görülen defekttir. Patofi zyolojisi iyi bilinmektedir. Tam düzeltme ameliyatlarının sonuçları yüz güldürücü olmakla birlikte, bazı özel durumlarda palyatif şant girişimlerine gereksinim olmaktadır. Tam düzeltme ameliyatlarının yaygın uygulamasına rağmen uzun dönemde gelişen rezidüel darlık sorun olabilmektedir. Uygun tedavinin seçilmesi için doğru tanı şarttır. Kardiyak manyetik rezonans görüntüleme doğuştan kalp defekti hakkında güvenilir ve kapsamlı bilgi sağlayabilmektedir. Bu yazıda, çocukluk döneminde TOF nedeniyle tam düzeltme ameliyatı yapılmış bir kadın hastada 28 yıl sonra gebelik sırasında saptanan ve yeniden ameliyatla tedavi edilen sağ ventrikül çıkım yolu darlığı sunuldu.Anahtar Kelimeler: Fallot tetralojisi; ventrikül çıkım yolu obstrüksiyonu; yeniden ameliyat Residual Obstruction Detected During Pregnancy 28 Years After Total Correction of Tetralogy of Fallot and Its Surgical Treatment ABSTRACTTetralogy of Fallot (TOF) is the most common syanotic heart defect, with well-known pathophysiology. Although total correction operations have excellent outcomes, palliative shunt procedures may be necessary in some situations. Despite the common use of total correction procedures, residual obstruction may develop in the long-term. Accurate diagnosis is essential for approppriate treatment. Cardiac magnetic resonance imaging provides reliable and comprehensive information about the nature of congenital heart defects. In this case report, we presented a woman who underwent reoperation for right ventricular outfl ow tract obstruction detected during pregnancy 28 years after total correction surgery of TOF.

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A 26-year experience with surgical management of tetralogy of fallot: risk analysis for mortality or late reintervention

Cited by 109 publications

References 29 publications

An audit of surgical repair of Tetralogy of Fallot in an African tertiary care centre

An audit of surgical repair of Tetralogy of Fallot in an African tertiary care centre

Late Results of Pediatric Cardiac Surgery in Finland

Residual Obstruction Detected During Pregnancy 28 Years After Total Correction of Tetralogy of Fallot and Its Surgical Treatment

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