Transatrial-transpulmonary repair of tetralogy of Fallot

Pacifico, Albert D.; Sand, Mark E.; Bargeron, Lionel M.; Colvin, Edward V.

doi:10.1016/s0022-5223(19)37053-9

Cited by 65 publications

(15 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Echocardiography revealed minimal pulmonary regurgitation in those patients with annulus enlargement. There was no significant gradient across the RVOT except in three patients whose RVOT gradient was greater than 12 patients, and showed normal data with good RVOT and PA whether with or without annulus enlargement.…”

Section: Resultsmentioning

confidence: 79%

“…The classic approach to repair tetralogy of Fallot (TOF) is through a right ventriculotomy.1-3 However, there have been reports of ventricular dysfunction and arrhythmia as a result of ventriculotomy.4-8 Therefore, as an alternative, a combined atrial and pulmonary artery approach may be used. [9][10][11][12][13] In 1989 we reported our experience of transpulmonary closure of ventricular septa1 defect (VSD), we also included in that report the patients with TOF.14 We believe that complete repair in TOF can be performed through the pulmonary artery (PA) alone.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Isolated Transpulmonary Repair of Tetralogy of Fallot

1995

View full text Add to dashboard Cite

Between October 1987 and November 1992, 165 consecutive patients underwent isolated transpulmonary repair for tetralogy of Fallot. Their ages ranged from 1 to 44 years and their weight ranged from 6 to 61 kg (mean 19.4). Of these 165 patients, 65% required annulus enlargement. The postrepair peak right ventricular/left ventricular pressure was 0.2 to 0.84 (mean 0.51). There were nine early deaths (5.5%) and one late death. All survivors have been followed up. Echocardiography revealed minimal to mild pulmonary regurgitation in those patients who had annulus enlargement. There were three patients who had gradient across the outflow tract of more than 40 mmHg. One of these required reoperation. We believe that all tetralogy of Fallot can be repaired through the pulmonary artery. Since we have used this approach for only 5 years, we are unable to compare the long-term results with those of other approaches.

show abstract

Section: Resultsmentioning

confidence: 79%

mentioning

confidence: 99%

Isolated Transpulmonary Repair of Tetralogy of Fallot

1995

View full text Add to dashboard Cite

show abstract

“…The outcome of the surgical repair was excellent with minimal morbidity and mortality. To date, no difference in operative mortality and morbidity rates has been noted between transventricular and transatrial approaches for total correction (7) . Nowadays there are current trend for preservation of the pulmonary valve function (PVF) by different surgical strategies to avoid the deleterious consequences of severe PR and right ventricular (RV) dysfunction.…”

Section: Introductionmentioning

confidence: 99%

The New Era in the Surgical Management of Tetrology of Fallot in Pediatric Patients : A Meta-Analysis

Elghanam

Zaki²,

El-Sayegh³

et al. 2018

Egyptian Journal of Hospital Medicine

View full text Add to dashboard Cite

Background: Provided the high incidence of Tetrology of Fallot, a compelling need for different surgical management techniques have been raised. Thus, a new era was developed in this field that gave favorable results, however a debate still exists on the optimal technique to relieve the Right Ventricular Outflow Tract Obstruction that could lead to less mortality and morbidity, hence it was necessary to analyze data that compare these different techniques. Moreover, there is a controversy between cardiac surgeons about the best technique to correct the RVOT in infants with Tetrology of fallot and so this study was done to compare between two frequent techniques according to their mortality and morbidity. Aim of the work: Assess the outcome after surgical repair of tetrology of fallot in pediatric patients comparing between transannular patch and valve sparing techniques. Methods: The present study was planned in accordance with current guidelines for performing comprehensive systemic reviews and meta-analysis including the PRISMA (Preferred Reporting Items For Systemic Review Meta-Analysis), MOOSE (Meta-analysis of Observational Studies in Epidemiology) and guidelines for randomized and nonrandomized studies. In this study a meta-analysis was done to compare between the two most common techniques (21-32) that are used to relieve the RVOT that are Transannular patch VS Valve Sparing Repair the variable chosen include: Mortality the Indexed Right Ventricular Volumes, QRS duration, incidence of pulmonary regurgitation, Right ventricular Ejection Fraction, Left Ventricular Ejection Fraction and incidence of Reoperation. The principal summary measures were difference in means with 95% confidence interval and p value (to be of significant if p < 0.005). The difference in means were combined across studies with MedCalc© version 15.8 (MedCalc© Software bvba, Ostend, Belgium. Results: A total of 72 citation were identified of which 20 studies were potentially relevant and retrieved in full text only 12 studies fulfilled the eligibility criteria There was 74% of patients had a TAP and 26% of patients had VSR. Mortality was 291 among patients with patch repair and 104 among valve sparing repair. Reoperation was detected in 7 patients with TAP VS 6 patients in VSR. Occurrence of PR was detected in 14 patients in TAP VS 12 patients in VSR. The study detected favorable measures in Indexed right ventricular volumes, RV ejection fraction and QRS duration in patients with VSR than those with TAP. This study detected that both group of patients had approximately equal results of LV ejection fraction. Conclusion: Our results reflected that Valve Sparing Repair for pediatric patients has better outcome in Mortality to relieve pulmonary stenosis, occurrence of pulmonary valve regurgitation as well as a less harmful effect on the right ventricular ejection fraction, better Indexed right ventricular volume and QRS duration than using transannular patching technique. Both transannular patching and valve sparing repair have approximately...

show abstract

“…Many recent reports have advocated the transatrial‐transpulmonary approach to repair of tetralogy of Fallot (TOF) in an effort to preserve right ventricular function over the long‐term 1,2 . The most critical point in surgical repair of TOF is infundibular dissection.…”

Section: Introductionmentioning

confidence: 99%