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

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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References

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Published

30-05-2024

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Original Articles

How to Cite

1.
Mehsood DK, Ahmad K, Ul-Haq I, Umair Younus R, Imran M, Majid M. Comparative Analysis in Early Outcomes of Different Surgical Repair Techniques in Adult Patients with Unrepaired Tetralogy of Fallot –10 Years Experience. Pak Armed Forces Med J [Internet]. 2024 May 30 [cited 2024 Jun. 16];74(SUPPL-1):S68-S73. Available from: https://pafmj.org/PAFMJ/article/view/11763