Outcomes of Total Surgical Correction for Tetralogy of Fallot in Benghazi
Keywords:Tetralogy of Fallot, Escarpments, surgery, Benghazi
Tetrology of Fallot (TOF) is the most common cyanotic congenital heart disease, accounting for 10% of all types of congenital heart disease. Despite decreased mortality rates by improvement in surgery and post-cardiac intensive care, there continues to be late postoperative complications. This study aimed to evaluate the outcomes after total repair of tetralogy of Fallot, including 44 children who underwent complete surgical repair between 2000 to 2018. Data were collected from medical records and directly from patients during their visit to the clinic, that included: history, clinical examination, gender, age at operation, results of ECG, Holter monitoring, echocardiography, cardiac catheterization, cardiac CT scan. Follow-up ranged from 6 months to18 years. Results revealed that the M/F ratio was 1.4:1. Also, two patients had a previous palliative systemic artery to PA shunt. A TAP was inserted in 22 (50%) patients. Postoperative complications were: severe PR 29%, small residual VSD 18.1%, and two patients had significant VSD which needed surgical intervention, residual RVOT 8.1%, RBBB 97.7%, There was three death (6.8%), and 36.3% of patients will need surgical intervention in the future. It was concluded that follow-ups up to adulthood to monitor potential complications are necessary. QRS duration is used for monitoring ventricular arrhythmia and sudden death. Echocardiography is a non-invasive tool in diagnosis, before and at the time of surgery, as well as in follow-ups.
Bhardwaj, V., Kapoor, P. M., Irpachi, K., Ladha, S., & Chowdhury, U. K. (2017). Basic arterial blood gas biomarkers as a predictor of mortality in tetralogy of Fallot patients. Annals of cardiac anaesthesia, 20(1), 67. DOI: https://doi.org/10.4103/0971-9784.197839
h Anderson, R., & m Weinberg, P. (2005). The clinical anatomy of tetralogy of Fallot. Cardiology in the Young, 15(s1), 38. DOI: https://doi.org/10.1017/S1047951105001010
Hashemzadeh, K., & Hashemzadeh, S. (2010). Early and late results of total correction of tetralogy of Fallot. Acta Medica Iranica, 117-122.
Ho, K. W., Tan, R. S., Wong, K. Y., Tan, T. H., Shankar, S., & Le Tan, J. (2007). Late complications following tetralogy of Fallot repair: the need for long-term follow-up. Annals-Academy of Medicine Singapore, 36(11), 947.
Kanter, K. R., Kogon, B. E., Kirshbom, P. M., & Carlock, P. R. (2010). Symptomatic neonatal tetralogy of Fallot: repair or shunt? The Annals of thoracic surgery, 89(3), 858-863. DOI: https://doi.org/10.1016/j.athoracsur.2009.12.060
Karl, T. R., & Stocker, C. (2016). Tetralogy of Fallot and its variants. Pediatric critical care medicine, 17(8), S330-S336. DOI: https://doi.org/10.1097/PCC.0000000000000831
Lee, J. R., Kim, J. S., Lim, H. G., Hwang, H. Y., Kim, Y. J., Rho, J. R., & Ahn, C. (2004). Complete repair of tetralogy of Fallot in infancy. Interactive cardiovascular and thoracic surgery, 3(3), 470-474. DOI: https://doi.org/10.1016/j.icvts.2004.04.002
Naidu, P., Grigg, L., & Zentner, D. (2017). Mortality in adults with congenital heart disease. International Journal of Cardiology, 245, 125-130. DOI: https://doi.org/10.1016/j.ijcard.2017.05.132
Scalone, G., Gomez-Monterrosas, O., Fiszer, R., Szkutnik, M., Gałeczka, M., & Białkowski, J. (2017). Combined strategy of Waterston shunt percutaneous occlusion and medical treatment with sildenafil for management of pulmonary hypertension in an adult patient with corrected tetralogy of Fallot. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, 13(3), 277-278. DOI: https://doi.org/10.5114/aic.2017.70204
Shahanavaz, S., Qureshi, A. M., Levi, D. S., Boudjemline, Y., Peng, L. F., Martin, M. H., Bauser-Heaton, H., Keeshan, B., Asnes, J. D., & Jones, T. K. (2018). Transcatheter pulmonary valve replacement with the melody valve in small diameter expandable right ventricular outflow tract conduits. JACC: Cardiovascular Interventions, 11(6), 554-564. DOI: https://doi.org/10.1016/j.jcin.2018.01.239
Sirivella, S., & Gielchinsky, I. (2014). Early and long term outcomes of corrective operations for tetralogy of Fallot: an experience of two centers. World Journal of Cardiovascular Surgery, 4(11), 186. DOI: https://doi.org/10.4236/wjcs.2014.411027
Smith, C. A., McCracken, C., Thomas, A. S., Spector, L. G., Oster, M. E., Moller, J. H., & Kochilas, L. (2019). Long-term outcomes of tetralogy of Fallot: a study from the pediatric cardiac care consortium. JAMA cardiology, 4(1), 34-41. DOI: https://doi.org/10.1001/jamacardio.2018.4255
Waqar, T., Riaz, M. U., & Mahar, T. (2017). Tetralogy of Fallot repair in patients presenting after Infancy: A single surgeon experience. Pakistan journal of medical sciences, 33(4), 984. DOI: https://doi.org/10.12669/pjms.334.12891
Wu, M. H., Lu, C. W., Chen, H. C., Kao, F. Y., & Huang, S. K. (2018). Adult congenital heart disease in a Nationwide population 2000–2014: epidemiological trends, arrhythmia, and standardized mortality ratio. Journal of the American Heart Association, 7(4), e007907. DOI: https://doi.org/10.1161/JAHA.117.007907
Zheng, D.-w., Shao, G.-f., Feng, Q., & Ni, Y.-m. (2013). Long-term outcome of correction of tetralogy of Fallot in 56 adult patients. Chinese medical journal, 126(19), 3675-3679.
How to Cite
Copyright (c) 2021 Marium Mohamed Mustafa, Rasmyia H. Elfatory, Aziza I. Gadwar, Khadija imhemed elshreef , Hagir M. Alshabi
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Copyright of the articles Published by Almukhtar Journal of Science (MJSc) is retained by the author(s), who grant MJSc a license to publish the article. Authors also grant any third party the right to use the article freely as long as its integrity is maintained and its original authors and cite MJSc as original publisher. Also they accept the article remains published by MJSc website (except in occasion of a retraction of the article).