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110970

Reoperations after the primary repair of tetralogy of Fallot; a single-center experience

Article

Last updated: 22 Jan 2023

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Abstract

Background: Reoperations after tetralogy of Fallot repair is common. This study aimed to report our indications, surgical procedures, and the clinical outcomes of patients undergoing reoperation after surgical correction of TOF. 
Patient and Methods: We included 40 patients who underwent reoperations after total TOF repair between 2015 and 2019. We included patients who had symptomatic right ventricular failure, patients with residual ventricular septal defect (VSD), right ventricular outflow tract obstruction (RVOTO), and tricuspid or pulmonary valve regurgitation.
Results: The median age was 5.5(3.5–12.5) years, and 28(70%) were males. The median age at the time of primary repair was 2 (1-6) years. The end-systolic right ventricular (RV) volume estimated by MRI was 110.33±4.93 cc, and the end-diastolic volume was 208 ±10.08 cc. Twenty-two patients had VSD closure (55%), a transannular patch in 6 patients (15%), and RVOT resection in 14 patients(35%). Pulmonary valve replacement was performed in 6 patients(15%) and tricuspid valve repair in 4 patients (10%). The duration of postoperative mechanical ventilation was 11.5 (9-16.5) hours, and two patients had operative mortality (5%). Two patients (5%) had residual RVOT pressure gradient, and four patients had tiny residual VSD(10%). After six months of follow-up, four patients had moderate pulmonary regurgitation (PR), and four patients had residual VSD (10%). After one year follow-up, two patients had moderate PR(5%). 
Conclusion: A residual ventricular septal defect is a common indication for reoperation after the primary repair of tetralogy of Fallot. The results of reoperations are good with the accepted incidence of postoperative morbidity and mortality.
 

DOI

10.21608/aimj.2020.34625.1267

Keywords

Tetralogy of Fallot, Reoperations, Residual ventricular septal defects

Authors

First Name

Ahmed

Last Name

Eldesouky

MiddleName

-

Affiliation

Cardiothoracic surgery department, Faculty of medicine, Al-Azhar University, cairo, Egypt.

Email

agtantawy@yahoo.com

City

cairo

Orcid

-

First Name

Elhusseiny

Last Name

Gamil

MiddleName

-

Affiliation

Cardiothoracic surgery department, Faculty of medicine, Al-Azhar University, cairo, Egypt.

Email

hgameil@idsc.net.eg

City

cairo

Orcid

-

First Name

Mohamed

Last Name

Sharaa

MiddleName

-

Affiliation

Cardiothoracic surgery department, Faculty of medicine, Al-Azhar University, cairo, Egypt.

Email

mohamed_sharaa1970@yahoo.com

City

Cairo

Orcid

-

First Name

Mohamed

Last Name

Mosa

MiddleName

-

Affiliation

Cardiothoracic surgery department, Faculty of medicine, Al-Azhar University, cairo, Egypt.

Email

mmosaomar76@yahoo.com

City

Cairo

Orcid

-

First Name

haytham

Last Name

abdelmoaty

MiddleName

-

Affiliation

Cardiothoracic surgery department, Faculty of medicine, Al-Azhar University, cairo, Egypt.

Email

drhaythabdelmoaty@gmail.com

City

cairo

Orcid

-

Volume

1

Article Issue

8

Related Issue

17482

Issue Date

2020-08-01

Receive Date

2020-07-04

Publish Date

2020-08-01

Page Start

103

Page End

106

Print ISSN

2682-3381

Online ISSN

2682-339X

Link

https://aimj.journals.ekb.eg/article_110970.html

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https://aimj.journals.ekb.eg/service?article_code=110970

Order

17

Type

Original Article

Type Code

710

Publication Type

Journal

Publication Title

Al-Azhar International Medical Journal

Publication Link

https://aimj.journals.ekb.eg/

MainTitle

-

Details

Type

Article

Created At

22 Jan 2023