Comparative Analysis in Early Outcomes of Different Surgical Repair Techniques in Adult Patients with Unrepaired Tetralogy of Fallot –10 Years Experience

Dawood Kamal Mehsood; Kaleem Ahmad; Intisar Ul-Haq; Rana Umair Younus; Muhammad  Imran; Muhammad Majid

doi:10.51253/pafmj.v74iSUPPL-1.11763

Authors

Dawood Kamal Mehsood Department of Paediatric Cardiac Surgery, Armed Forces Institute of Cardiology/National Institute of Heart Diseases National University of Medical Sciences (NUMS), Rawalpindi, Pakistan
Kaleem Ahmad Department of Paediatric Cardiac Anesthesia, Armed Forces Institute of Cardiology/National Institute of Heart Diseases, National University of Medical Sciences (NUMS), Rawalpindi, Pakistan
Intisar Ul-Haq Department of Paediatric Cardiac Surgery, Armed Forces Institute of Cardiology/National Institute of Heart Diseases National University of Medical Sciences (NUMS), Rawalpindi, Pakistan
Rana Umair Younus Department of Paediatric Cardiac Anesthesia, Armed Forces Institute of Cardiology/National Institute of Heart Diseases, National University of Medical Sciences (NUMS), Rawalpindi, Pakistan
Muhammad Imran Department of Paediatric Cardiac Surgery, Armed Forces Institute of Cardiology/National Institute of Heart Diseases National University of Medical Sciences (NUMS), Rawalpindi, Pakistan
Muhammad Majid Department of Paediatric Cardiac Surgery, Armed Forces Institute of Cardiology/National Institute of Heart Diseases National University of Medical Sciences (NUMS), Rawalpindi, Pakistan

DOI:

https://doi.org/10.51253/pafmj.v74iSUPPL-1.11763

Keywords:

Pulmonary Valve Sparing, Pulmonary Valve Replacement, Tetralogy Of Fallot, Transannular Patch, Outcomes

Abstract

Objective: To compare early outcomes of different surgical repair techniques used in adult patients with unrepaired Tetralogy of Fallot.

Study Design: Analytical Cross-sectional study.

Place and Duration of Study: Armed Forces Institute of Cardiology/National Institute of Heart Diseases, Rawalpindi Pakistan, from Jan 2014 to Dec 2023.

Methodology: Seventy seven adults with unrepaired Tetralogy of Fallot were recruited through universal sampling and divided into 3 groups of Tetralogy of Fallot repair techniques, Group A: Pulmonary Valve Sparing, Group B: Transannular patch +MonoCusp, Group C: TAP+Pulmonary Valve Replacement. Chi-square and one-way ANOVA were applied to compare early outcomes like Cardiopulmonary Bypass time, Aortic cross clamp time, reopening for bleeding, mortality, in-hospital stay etc. with repair techniques. p<0.05 was considered as statistically significant.

Results: Out of seventy seven patients, 50(64.9%) were males and 27(35.1%) were females. Median age of participants was 19(IQR=18-22) years. Group A had 35(45.5%) patients, while Group B and Group C included 20(25.9%) and 22(28.6%) patients respectively. Group A had shorter CBP time, ACC time, Intensive Care Unit stay and inotropic support etc. (p<0.05). Single case of mortality in group A 1(2.9%) out of 35 and in Group C 1(4.5%) out of 22 patients was observed, while high mortality of 4(20.0%) cases was observed in Group B.

Conclusion: Efforts should be made to preserve the patient's native pulmonary valve and annulus since PVS TOF repair provides better early results. When dividing, a hypoplastic pulmonary valve annulus cannot be avoided. TAP + PVR produces better results than TAP + MonoCusp.

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