Reintervention after repair of tetralogy of Fallot: a one-decade single-center experience
Abstract Background Reinterventions after tetralogy of Fallot repair (TOF) remains a common clinical problem. The objective of this study was to evaluate types of reintervention after TOF repair and identify the risk factors for reinterventions. Methods This retrospective study was conducted from 20...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2023-01-01
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| Series: | The Cardiothoracic Surgeon |
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| Online Access: | https://doi.org/10.1186/s43057-023-00096-9 |
| _version_ | 1811175725023100928 |
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| author | Mohamed H. Mashali Aly A. Yousef Ahmed F. Elmahrouk Wejdan Ba-Atiyah Mohammed A. Rasol Mohamad A. Arafa Mohammad S. Shihata Ahmed A. Jamjoom Tamer E. Hamouda |
| author_facet | Mohamed H. Mashali Aly A. Yousef Ahmed F. Elmahrouk Wejdan Ba-Atiyah Mohammed A. Rasol Mohamad A. Arafa Mohammad S. Shihata Ahmed A. Jamjoom Tamer E. Hamouda |
| author_sort | Mohamed H. Mashali |
| collection | DOAJ |
| description | Abstract Background Reinterventions after tetralogy of Fallot repair (TOF) remains a common clinical problem. The objective of this study was to evaluate types of reintervention after TOF repair and identify the risk factors for reinterventions. Methods This retrospective study was conducted from 2010 to 2022 and included 171 patients with complete TOF repair. Patients were grouped according to the occurrence of reintervention into two groups: patients who did not have reintervention (n = 138) and those who required reintervention (n = 33). Results Median follow-up was 36 (13–67) months. The first reintervention was required in 33 patients. Freedom from the first reintervention at 1, 3, 5, and 7 years was 91%, 85%, 81%, and 76%, respectively. Surgical reintervention was required in 12 patients and transcatheter intervention in 21 patients. Second reinterventions were required in 11 patients; 4 had surgery, and 7 had a transcatheter intervention. Third reinterventions were performed on two patients; one had surgery, and one had a transcatheter intervention. The most common interventions were performed at the level of pulmonary arteries (n = 17), followed by the pulmonary valve and the right ventricular outflow tract (n = 15). The risk of reintervention was associated with the low weight (HR: 0.65 (95% CI: 0.48–0.88); P = 0.005) and small LPA diameter (HR: 0.36 (95% CI: 0.21–0.60); P < 0.001) at the time of the primary intervention and the nonuse of the transannular patch (HR: 0.27 (95% CI: 0.08–0.85); P = 0.026). Conclusions The risk of reintervention is high after tetralogy of Fallot repair. In our experience, the smaller the left pulmonary artery and weight at the repair time increased the risk of reintervention. Using a transannular patch in our series was associated with a lower risk of reintervention. |
| first_indexed | 2024-04-10T19:41:32Z |
| format | Article |
| id | doaj.art-fcf366f2a3744e0e9ade7eeef6ba1251 |
| institution | Directory Open Access Journal |
| issn | 2662-2203 |
| language | English |
| last_indexed | 2024-04-10T19:41:32Z |
| publishDate | 2023-01-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | The Cardiothoracic Surgeon |
| spelling | doaj.art-fcf366f2a3744e0e9ade7eeef6ba12512023-01-29T12:22:14ZengSpringerOpenThe Cardiothoracic Surgeon2662-22032023-01-013111610.1186/s43057-023-00096-9Reintervention after repair of tetralogy of Fallot: a one-decade single-center experienceMohamed H. Mashali0Aly A. Yousef1Ahmed F. Elmahrouk2Wejdan Ba-Atiyah3Mohammed A. Rasol4Mohamad A. Arafa5Mohammad S. Shihata6Ahmed A. Jamjoom7Tamer E. Hamouda8Pediatric Cardiology Department, King Faisal Specialist Hospital and Research CenterDivision of Pediatric Critical Care, Department of Pediatrics, King Faisal Specialist Hospital and Research CenterDivision of Cardiac Surgery, Cardiovascular Department, King Faisal Specialist Hospital and Research CenterPediatric Cardiology Department, King Faisal Specialist Hospital and Research CenterPediatric Cardiology Department, King Faisal Specialist Hospital and Research CenterDivision of Pediatric Critical Care, Department of Pediatrics, King Faisal Specialist Hospital and Research CenterDivision of Cardiac Surgery, Cardiovascular Department, King Faisal Specialist Hospital and Research CenterDivision of Cardiac Surgery, Cardiovascular Department, King Faisal Specialist Hospital and Research CenterDivision of Cardiac Surgery, Cardiovascular Department, King Faisal Specialist Hospital and Research CenterAbstract Background Reinterventions after tetralogy of Fallot repair (TOF) remains a common clinical problem. The objective of this study was to evaluate types of reintervention after TOF repair and identify the risk factors for reinterventions. Methods This retrospective study was conducted from 2010 to 2022 and included 171 patients with complete TOF repair. Patients were grouped according to the occurrence of reintervention into two groups: patients who did not have reintervention (n = 138) and those who required reintervention (n = 33). Results Median follow-up was 36 (13–67) months. The first reintervention was required in 33 patients. Freedom from the first reintervention at 1, 3, 5, and 7 years was 91%, 85%, 81%, and 76%, respectively. Surgical reintervention was required in 12 patients and transcatheter intervention in 21 patients. Second reinterventions were required in 11 patients; 4 had surgery, and 7 had a transcatheter intervention. Third reinterventions were performed on two patients; one had surgery, and one had a transcatheter intervention. The most common interventions were performed at the level of pulmonary arteries (n = 17), followed by the pulmonary valve and the right ventricular outflow tract (n = 15). The risk of reintervention was associated with the low weight (HR: 0.65 (95% CI: 0.48–0.88); P = 0.005) and small LPA diameter (HR: 0.36 (95% CI: 0.21–0.60); P < 0.001) at the time of the primary intervention and the nonuse of the transannular patch (HR: 0.27 (95% CI: 0.08–0.85); P = 0.026). Conclusions The risk of reintervention is high after tetralogy of Fallot repair. In our experience, the smaller the left pulmonary artery and weight at the repair time increased the risk of reintervention. Using a transannular patch in our series was associated with a lower risk of reintervention.https://doi.org/10.1186/s43057-023-00096-9Tetralogy of Fallot repairResidual defectsPulmonary incompetencePulmonary arteryTransannular patchRight ventricular outflow tract |
| spellingShingle | Mohamed H. Mashali Aly A. Yousef Ahmed F. Elmahrouk Wejdan Ba-Atiyah Mohammed A. Rasol Mohamad A. Arafa Mohammad S. Shihata Ahmed A. Jamjoom Tamer E. Hamouda Reintervention after repair of tetralogy of Fallot: a one-decade single-center experience The Cardiothoracic Surgeon Tetralogy of Fallot repair Residual defects Pulmonary incompetence Pulmonary artery Transannular patch Right ventricular outflow tract |
| title | Reintervention after repair of tetralogy of Fallot: a one-decade single-center experience |
| title_full | Reintervention after repair of tetralogy of Fallot: a one-decade single-center experience |
| title_fullStr | Reintervention after repair of tetralogy of Fallot: a one-decade single-center experience |
| title_full_unstemmed | Reintervention after repair of tetralogy of Fallot: a one-decade single-center experience |
| title_short | Reintervention after repair of tetralogy of Fallot: a one-decade single-center experience |
| title_sort | reintervention after repair of tetralogy of fallot a one decade single center experience |
| topic | Tetralogy of Fallot repair Residual defects Pulmonary incompetence Pulmonary artery Transannular patch Right ventricular outflow tract |
| url | https://doi.org/10.1186/s43057-023-00096-9 |
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