COMPARATIVE STUDY TO EVALUATE THE EFFICACY OF TRANSTHORACIC ECHOCARDIOGRAPHY VERSUS CARDIAC CATHETERIZATION FOR PRE OPERATIVE ASSESSMENT OF TETRALOGY OF FALLOT

Abstract

Objective: To determine the results of transthoracic echocardiography and cardiac catheterization for pre operative assessment of Tetralogy of Fallot and operative outcomes for the patients.

Study Design: Case Series; prospective descriptive study.

Place and Duration of Study: Armed Forces Institute of Cardiology/National Institute of Heart Diseases, Rawalpindi, Jan 2006 to December 2010.
Patients and Methods: All patients admitted in AFIC/NIHD for surgical repair of Tetralogy of Fallot.

Results: A total of 746 patients were included in study, male (33%), female (67%), mean age was 4.7 years. Group I was evaluated for total correction with combined transthoracic two dimensional echocardiography and cardiac catheterization, and group II was subjected to transthoracic two dimensional echocardiography only for pre operative assessment. Overall mortality was 8.4% in group I and 10.8% in group II. In group II, 84% had total correction and 16% had closed heart, while in group II 73% had open heart and 27% had closed heart surgery.

Conclusion: Tetralogy of Fallot is the leading cause of cyanotic congenital cardiac heart disease. The pre operative evaluation with help of Transthoracic two dimensional echocardiography requires oral sedation, is cost effective and minimally invasive. Cardiac catheterization being reserved for the patients having inadequate information on Transthoracic echocardiography. Early surgery during childhood has long term benefits in terms of morbidity and lifestyle adjustment.