Intracardiac correction of tetralogy of fallot in the first year of life: short-term and mid-term results

• Published in: Revista brasileira de cirurgia cardiovascular : orgao oficial da Sociedade Brasileira de Cirurgia Cardiovascular Vol. 23; no. 2; p. 216
• Main Authors: Moraes Neto, Fernando Ribeiro de, Santos, Cleusa Cavalcanti Lapa, Moraes, Carlos Roberto Ribeiro de
• Format: Journal Article
• Language: English
• Published: Brazil 01-04-2008
• Subjects: Cardiac Surgical Procedures - methods; Female; Follow-Up Studies; Humans; Infant; Kaplan-Meier Estimate; Magnetic Resonance Angiography; Male; Postoperative Period; Reoperation; Tetralogy of Fallot - diagnosis; Tetralogy of Fallot - mortality; Tetralogy of Fallot - surgery; Time Factors; Treatment Outcome; Ventricular Function - physiology

To evaluate short-term and medium-term results of intracardiac correction of tetralogy of fallot in the first year of life.
From January 1996 to October 2004, 67 consecutive infants ranging in age from 1 to 11 months (mean: 7.2 months) and weighing from 4 to 10 kilograms (mean: 7.1 kilograms) underwent elective total correction of tetralogy of fallot. The surgery was accomplished with conventional cardiopulmonary bypass and moderate hypothermia. Right ventriculotomy was performed in 60 (89.5%) cases and an atriopulmonary approach was used in the other seven (10.5%) cases.
Cardiopulmonary bypass time ranged from 35 to 147 minutes (mean: 78.8 +/- 21 minutes), and aortic clamping time ranged from 25 to 86 minutes (mean: 51.8 +/- 15.6 minutes). Transannular enlargement of the right ventricular outflow tract was needed in 50 (64.1%) patients. Gradient between the right ventricle and pulmonary artery after correction varied from 0 to 54 mmHg (mean: 15.5 +/- 10.8 mmHg). There were two (2.98%) early deaths. Follow-up of the 65 survivors ranged from 7 to 115 months (mean:44.0 +/- 35 months). There was one late noncardiac death. All other patients are asymptomatic. The actuarial survival curve at 12 years, including operative mortality, was 97%. Ten patients were evaluated by magnetic nuclear angioresonance.
Intracardiac correction of tetralogy of fallot in the first year of life may be performed with low morbidity and mortality and good late results.