The Surgical Treatment of Tetralogy of Fallot

Sánchez, Héctor Alan Mendoza; Cornish, E.M.; Shih, Feng Chu; Nóbrega, João; Hassoulas, J; Netto, José Corrêa Lima; Thornington, R; Barnard, C. N.

doi:10.1016/s0003-4975(10)60774-6

Cited by 9 publications

(2 citation statements)

References 20 publications

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“…Bazı yazarlar pulmoner arter çaplarının küçük olduğu durumlarda ventriküler septal defekt (VSD)'in kapatılmasıyla tam düzeltme sonrasında sağ ventrikül (RV) basıncının önemli ölçüde yükseldiğini ve buna bağlı olarak kardiyak debinin düştüğünü ve RV yetmezliğinin geliştiğini öne sürmektedir (9)(10)(11)(12) . Postoperatif RV basıncının yükselmesi ve bunun sonucunda gelişen kalp yetmezliğinden (13) kaçınmak ve mortaliteyi düşürebilmek amacıyla araştırmacılar preoperatif hasta seçiminde bazı kriterler geliştirmiş-lerdir.…”

Section: Discussionunclassified

Factors affecting pulmonary artery development indices prior to total correction in cases with Tetralogy of Fallot: An observational review in 100 case

Özdemir¹,

Öner²,

Demirpençe³

et al. 2015

Behcet Uz Cocuk Hast Derg

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ÖZETAmaç: Fallot tetralojisi tanısı konulan hastaların tam düzeltme ameliyatı öncesi pulmoner arter gelişimini gösteren McGoon oranı, Nakata indeksi, pulmoner arter Z skoru ile arkus aortanın seyri, patent foramen ovalenin (PFO) varlığı veya yokluğu ve hastanın cinsiyeti arasındaki ilişkinin değerlendirilmesi amaçlandı. Yöntemler: Ocak 2003 ile Ocak 2011 tarihleri arasında Fallot tetralojisi tanısı ile tam düzeltme ameliyatı önce-si diyagnostik anjiografi yapılan, öncesinde şant cerrahisi geçirmeyen 100 olgu çalışmaya alındı. Retrospektif olarak ekokardiyografi ile elde edilen sol ventrikül diyastol sonu çapı (LVEDd), PFO ve arkus aortanın seyri, anjiografik olarak ölçülen McGoon oranı, Nakata indeksi, pulmoner arter Z skoru değerlendirildi. Bulgular: Olguların %72'si erkek, %28'i kızdı. Median yaş 21 ay (min: 4 ay max: 228 ay) olan hastaların doğum ağırlıkları ise 2960±550 gramdı. Hastalarda sol arkus aorta hâkimiyeti (%77) izlendi. LVEDd %18 hastada normalin altındaydı. PFO %23, koroner anomali %4, majör aorto pulmoner kollateral arterler (MAPCA) %3, sol superior vena kava %6 oranındaydı. PFO'su olan hastalarda pulmoner arter Z skoru olmayanlara göre daha düşük bulundu (p<0.05). Arkus aorta seyrinin ve cinsiyetin ise hastalar arasında fark oluşturmadığı izlendi. Sonuç: Fallot tetralojili hastalarda PFO'nun varlığı pulmoner arter Z skorunu etkileyebilir. Bunun yanı sıra arkus aorta seyrinin ve cinsiyetin tam düzeltme ameliyatı öncesi pulmoner arter gelişimini etkileyen faktörler olmadığını düşünmekteyiz.Anahtar kelimeler: Fallot tetralojisi, pulmoner arter gelişim indeksleri, patent foramen ovale, arkus aorta ABSTRACT Objective: The present study aimed to evaluate the association between the equations indicating the pulmonary artery development prior to total correction surgery in patients diagnosed with Tetralogy of Fallot, such as McGoon ratio, Nakata index and pulmonary artery Z score and the course of aortic arch, presence/absence of accompanying patent foramen ovale (PFO) and the patient's gender. Methods: The study included 100 cases who had diagnostic angiography before the total correction surgery with the diagnosis of Tetralogy of Fallot between January 2003 and January 2011. The study retrospectively evaluated using estimated angiographic parametres as left ventricular end-diastolic diameter (LVEDd), the presence of PFO and the course of aortic arch as obtained by echocardiography, and the McGoon ratio, Nakata index and pulmonary artery Z scores. Results: Of the patients, 72% were male and 28% were female. The median age was 21 months (min: 4,max: 228 mos) and the birth weight was 2960±550 gram. Left aortic arch dominancy (77%) was observed. LVEDd was below normal in 18% of the patients. PFO, coronary abnormalities, MAPCA, left superior vena were seen in 23, 4, 3, and 6% of the patients respectively. Pulmonary artery Z scores were found lower in patients with PFO compared to those without PFO (p<0.05). The course of aortic arch and gender were not different among the patients. Conclusion:The presence ...

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Section: Discussionunclassified

Factors affecting pulmonary artery development indices prior to total correction in cases with Tetralogy of Fallot: An observational review in 100 case

Özdemir¹,

Öner²,

Demirpençe³

et al. 2015

Behcet Uz Cocuk Hast Derg

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“…Most children born with complex congenital heart disease now reach adulthood. Post-surgery mortality following surgical correction, of tetralogy of Fallot, for example, has fallen from 5.5% in 19801 to 0% in 2016 2. However, as long-term survival has improved late sequelae have become evident.…”

Section: Introductionmentioning

confidence: 99%

‘Off pump’ self-expanding injectable tissue valves (IPVR) versus ‘on pump’ conventional tissue valves (PVR) for replacement of the pulmonary valve: trial protocol for a randomised controlled trial (InVITe trial)

et al. 2019

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IntroductionPatients with congenital heart disease often need repeated operations throughout life to replace the pulmonary valve. Valve replacement with ‘injectable’ self-expanding valves (which is performed ‘off pump’ without the use of cardiopulmonary bypass, CPB) may result in quicker recovery and lower risk of major complications than valve replacement with conventional valves (which is performed ‘on pump’ with the use of CPB).Methods and analysisWe are conducting a multicentre, single-blind randomised controlled trial in patients with congenital heart disease and aged between 12 and 80 years. We will randomise participants in a 1:1 ratio to receive either ‘off pump’ injectable pulmonary valve replacement or ‘on pump’ conventional pulmonary valve replacement. The primary outcome will be the difference between the groups with respect to post-surgery blood loss (as measured by chest drain volume) in the first 24 hours. Secondary outcomes will include in-hospital outcomes (intensive care unit stay, inotropic/vasodilator support, chest drain volume in the first 12 hours post-surgery, time of readiness for extubation, blood products used in the first 24 hours post-surgery, time of fitness for discharge, valve and heart function 6 months post-surgery (assessed using cardiovascular magnetic resonance and ECHOCARDIOGRAPHY) and health-related quality of life 6 weeks and 6 months post-surgery.Ethics and disseminationThis trial has been approved by the South West Exeter Research Ethics Committee. Findings will be shared with participating hospitals and disseminated to the academic community through peer reviewed publications and presentation at national and international meetings. Patients will be informed of the results through patient organisations and newsletters to participants.Trial registration numberISRCTN23538073

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Rechtsventrikulärer Ausflußtrakt

Klinner¹,

Reichart²

1991

Herzchirurgie

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The Surgical Treatment of Tetralogy of Fallot

Cited by 9 publications

References 20 publications

Factors affecting pulmonary artery development indices prior to total correction in cases with Tetralogy of Fallot: An observational review in 100 case

Factors affecting pulmonary artery development indices prior to total correction in cases with Tetralogy of Fallot: An observational review in 100 case

‘Off pump’ self-expanding injectable tissue valves (IPVR) versus ‘on pump’ conventional tissue valves (PVR) for replacement of the pulmonary valve: trial protocol for a randomised controlled trial (InVITe trial)

Rechtsventrikulärer Ausflußtrakt

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