S-Space College of Medicine/School of Medicine (의과대학/대학원) Thoracic Surgery (흉부외과학전공) Journal Papers (저널논문_흉부외과학전공)
Outcome after one-stage repair of tetralogy of Fallot
- Lee, C; Lee, C N; Kim, S C; Lim, C; Chang, Y H; Kang, C H; Jo, W M; Kim, W H
- Issue Date
- Edizione Minerva Medica
- J Cardiovasc Surg (Torino). 2006 Feb;47(1):65-70.
- Abnormalities, Multiple/epidemiology; Adolescent; Adult; Age Factors; *Cardiac Surgical Procedures; Child; Child, Preschool; Female; Humans; Infant; Male; Middle Aged; Reoperation; Tetralogy of Fallot/epidemiology/*surgery; Treatment Outcome
- AIM: The purpose of this study was to evaluate the outcome after one-stage repair of tetralogy of Fallot (TOF). METHODS: Between May 1997 and December 2002, 240 patients with a median age of 9 months (1 month-48 years) underwent one-stage repair of TOF. Closure of ventricular septal defect (VSD) was accomplished through the right atrium in 171 (71.3%) patients and through the right ventricle in 69 (28.7%) patients. For the reconstruction of the right ventricular outflow tract (RVOT), transannular repair was performed in 151 (62.9%) patients, and non-transannular repair was performed in 89 (37.1%) patients. Follow-up was complete, averaging 40+/-17.6 months (3 months-5.8 years). RESULTS: There were 2 (0.8%) operative deaths. Between early repair group (age under 6 months) and late repair group (age above 6 months), there were no differences in the method of RVOT reconstruction (transannular vs non-transannular) and the need for branch pulmonary artery angioplasty. Early repair group had more transventricular VSD closure than late repair group (46% vs 22%, P < 0.05). Duration of inotropic support and intensive care unit (ICU) stay were longer in the early repair group (P < 0.05). Five patients required reoperations due to RVOT obstruction (n = 3), and residual VSD (n = 2). Kaplan-Meier freedom from reoperation at 5 years was 98.3+/-1%. Nine patients underwent catheter intervention for branch pulmonary artery stenosis. Freedom from reintervention at 5 years was 95.4+/-1.5%. All survivors are currently asymptomatic. CONCLUSIONS: One-stage repair of TOF could be performed with low mortality and morbidity. Especially, early one-stage repair in symptomatic infant could be performed with low risk, eliminating the need for palliative procedures.
- 0021-9509 (Print)
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