Tariq Waqar Yasir Khan, Anjum Jalal.
Surgical repair of Tetralogy of Fallot in children and adult patients: a Retrospective analysis of early results.
Pak J Med Health Sci Jan ;7(1):12-5.

Objective: To analyse early results of surgical repair of Tetralogy of Fallot in children and adults. Patients & methods: It is a retrospective study of all patients operated for surgical repair of Tetralogy of Fallots by one surgeon in period of 46 months. These included 129 patients i.e. 88(68%) male 41(32%) female patients. The data was retrieved from the electronic database. The numeric variables were summarized as mean, median and standard deviation while the categoric variables were presented as frequency and percentage. The study was done in accordance with the guidelines of Helsinki conventions. Results: The mean age at the time of operation was 14.9±6.48 years. The mean weight was 31.04±12.59 kg. The mean preoperative EF was 60.59±6.59 percent while mean Haemoglobin was 15.85±3.64 gm/dl and mean serum creatinine was 0.78±0.13mg/dl.gh The most common form of VSD was perimembranous (n=100). Four patients had previous modified Blalock Tausing shunts. The PA was closed directly in 55 patients and was augmented with a patch in another 55 patients. Transannular patch was used in 20 patients. Patch arterioplasty was done for right PA in 4 patients and left PA in 6 patients. Right Ventricular Outflow Tract (RVOT) was augmented with patch in 9 patients. The mean bypass time was 120.46 minutes and the mean cross clamp time was 88.71 minutes. The average ICU stay was 54.16 hours and the hospital stay was 8.8 days. Complications included pericardial effusion (n=4), pleural effusion (n=4), complete heart block requiring permanent pacemaker (n=3), insignificant residual VSD (n=7), moderate tricuspid insufficiency (n=6), and moderate/sever pulmonary insufficiency (n=9). There were 2-deaths within 90 days of operation. Conclusion: Transatrial /transpulmonary repair of TOF can produce excellent results in grown-up children and adults. However, it requires aggressive ICU management.

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