Outcome of humanitarian patients with late complete repair of tetralogy of Fallot: A 13-year long single-center experience
Background: Surgical repair of tetralogy of Fallot is usually performed between 3 and 6 months of age with pulmonary valve-sparing repair promoted for the best long-term result. Through a humanitarian program from developing countries, late complete surgical repair of tetralogy of Fallot has been pe...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-12-01
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| Series: | International Journal of Cardiology Congenital Heart Disease |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666668522000970 |
| _version_ | 1817999236320460800 |
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| author | Damien Schaffner Guillaume Maitre Sebastiano A.G. Lava Yann Boegli Mirko Dolci Raymond Pfister Nicole Sekarski Perez Marie-Hélène Stefano Di Bernardo |
| author_facet | Damien Schaffner Guillaume Maitre Sebastiano A.G. Lava Yann Boegli Mirko Dolci Raymond Pfister Nicole Sekarski Perez Marie-Hélène Stefano Di Bernardo |
| author_sort | Damien Schaffner |
| collection | DOAJ |
| description | Background: Surgical repair of tetralogy of Fallot is usually performed between 3 and 6 months of age with pulmonary valve-sparing repair promoted for the best long-term result. Through a humanitarian program from developing countries, late complete surgical repair of tetralogy of Fallot has been performed at our institution for many years. Methods: Retrospective analysis of pre- and perioperative data, as well as 30-days outcome of patients older than one year with a confirmed diagnosis of tetralogy of Fallot who had a complete surgical repair between 2005 and 2018 at our institution. Results: One hundred sixty-five patients were included with a median age of 4.5 years [3.0–6.3], median weight of 13.5 kg [10.9 to 16.5], median transcutaneous oximetry of 78% [70 to 85] and median pulmonary valve annulus Z-score of −1.8 [-3.4 to −0.8]. There was no early surgical mortality. By multivariate analysis, only severe right ventricular hypertrophy, severe right ventricle outflow tract obstruction, and hypoplasia of the main pulmonary artery were independent predictors of failure to preserve the pulmonary annulus at surgical repair. Conclusions: Late complete surgical repair of tetralogy of Fallot has low mortality and morbidity even when pulmonary valve-sparing repair cannot be successfully performed. The preservation of the pulmonary valve function is significantly associated with shorter ventilation time, ICU and hospital lengths of stay. In the analyzed group of patients, a pulmonary valve-sparing repair cannot be predicted exclusively based on the dimension of the pulmonary valve annulus. |
| first_indexed | 2024-04-14T03:06:01Z |
| format | Article |
| id | doaj.art-4a357836dfe949c7b1c5b6905ff5da0a |
| institution | Directory Open Access Journal |
| issn | 2666-6685 |
| language | English |
| last_indexed | 2024-04-14T03:06:01Z |
| publishDate | 2022-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Cardiology Congenital Heart Disease |
| spelling | doaj.art-4a357836dfe949c7b1c5b6905ff5da0a2022-12-22T02:15:45ZengElsevierInternational Journal of Cardiology Congenital Heart Disease2666-66852022-12-0110100414Outcome of humanitarian patients with late complete repair of tetralogy of Fallot: A 13-year long single-center experienceDamien Schaffner0Guillaume Maitre1Sebastiano A.G. Lava2Yann Boegli3Mirko Dolci4Raymond Pfister5Nicole Sekarski6Perez Marie-Hélène7Stefano Di Bernardo8Pediatric Cardiology Unit, Women Mother and Child Department, Lausanne University Hospital, SwitzerlandIntensive Care Unit, Women Mother and Child Department, Lausanne University Hospital, SwitzerlandPediatric Cardiology Unit, Women Mother and Child Department, Lausanne University Hospital, SwitzerlandPediatric Anesthesiologic Unit, Anesthesiologic Department, Lausanne University Hospital, SwitzerlandPediatric Anesthesiologic Unit, Anesthesiologic Department, Lausanne University Hospital, SwitzerlandCardiac Surgery Department, Lausanne University Hospital, SwitzerlandPediatric Cardiology Unit, Women Mother and Child Department, Lausanne University Hospital, SwitzerlandIntensive Care Unit, Women Mother and Child Department, Lausanne University Hospital, SwitzerlandPediatric Cardiology Unit, Women Mother and Child Department, Lausanne University Hospital, Switzerland; Corresponding author. Women-Mother-child Department, Pediatric Cardiologic Unit, Lausanne University Hospital and Lausanne University, Rue du Bugnon 46, 1011, Lausanne, Switzerland.Background: Surgical repair of tetralogy of Fallot is usually performed between 3 and 6 months of age with pulmonary valve-sparing repair promoted for the best long-term result. Through a humanitarian program from developing countries, late complete surgical repair of tetralogy of Fallot has been performed at our institution for many years. Methods: Retrospective analysis of pre- and perioperative data, as well as 30-days outcome of patients older than one year with a confirmed diagnosis of tetralogy of Fallot who had a complete surgical repair between 2005 and 2018 at our institution. Results: One hundred sixty-five patients were included with a median age of 4.5 years [3.0–6.3], median weight of 13.5 kg [10.9 to 16.5], median transcutaneous oximetry of 78% [70 to 85] and median pulmonary valve annulus Z-score of −1.8 [-3.4 to −0.8]. There was no early surgical mortality. By multivariate analysis, only severe right ventricular hypertrophy, severe right ventricle outflow tract obstruction, and hypoplasia of the main pulmonary artery were independent predictors of failure to preserve the pulmonary annulus at surgical repair. Conclusions: Late complete surgical repair of tetralogy of Fallot has low mortality and morbidity even when pulmonary valve-sparing repair cannot be successfully performed. The preservation of the pulmonary valve function is significantly associated with shorter ventilation time, ICU and hospital lengths of stay. In the analyzed group of patients, a pulmonary valve-sparing repair cannot be predicted exclusively based on the dimension of the pulmonary valve annulus.http://www.sciencedirect.com/science/article/pii/S2666668522000970Tetralogy of FallotLate complete surgical repairHumanitarian patientsPulmonary valve-sparing repairPulmonary valve annulusPostoperative outcome |
| spellingShingle | Damien Schaffner Guillaume Maitre Sebastiano A.G. Lava Yann Boegli Mirko Dolci Raymond Pfister Nicole Sekarski Perez Marie-Hélène Stefano Di Bernardo Outcome of humanitarian patients with late complete repair of tetralogy of Fallot: A 13-year long single-center experience International Journal of Cardiology Congenital Heart Disease Tetralogy of Fallot Late complete surgical repair Humanitarian patients Pulmonary valve-sparing repair Pulmonary valve annulus Postoperative outcome |
| title | Outcome of humanitarian patients with late complete repair of tetralogy of Fallot: A 13-year long single-center experience |
| title_full | Outcome of humanitarian patients with late complete repair of tetralogy of Fallot: A 13-year long single-center experience |
| title_fullStr | Outcome of humanitarian patients with late complete repair of tetralogy of Fallot: A 13-year long single-center experience |
| title_full_unstemmed | Outcome of humanitarian patients with late complete repair of tetralogy of Fallot: A 13-year long single-center experience |
| title_short | Outcome of humanitarian patients with late complete repair of tetralogy of Fallot: A 13-year long single-center experience |
| title_sort | outcome of humanitarian patients with late complete repair of tetralogy of fallot a 13 year long single center experience |
| topic | Tetralogy of Fallot Late complete surgical repair Humanitarian patients Pulmonary valve-sparing repair Pulmonary valve annulus Postoperative outcome |
| url | http://www.sciencedirect.com/science/article/pii/S2666668522000970 |
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