PRESERVATION OF PULMONARY VALVE THROUGH TRANSATRIAL AND TRANSVENTRICULAR APPROACH IN PRIMARY REPAIR OF TETRALOGY OF FALLOT (TOF);; A SINGLE CENTERED RETROSPECTIVE ANALYSIS

Abstract

Objective: To evaluate the effect of preserving pulmonary valve in total correction for Tetralogy of Fallot

Study Design: Descriptive Cross-sectional study.

Place and Duration of Study: Department of Paeds Cardiac Surgery of Armed Forces Institute of Cardiology and National Institute of Heart Disease (AFIC/NIHD), from Sep 2017 to Oct 2018.

Material and Methods: Tetralogy of Fallot (TOF) in 50 cases done by a single operator, were studied for early post-operative outcomes. A total of 50 patients with classic TOF were included in this study. There were 33(66%) males and 17 (34%) females. Their age ranged from 1-15 years with a mean age of 7.32 ± 4.97 years.
Total correction for tetralogy of Fallot was done through primary repair securing the integrity of the pulmonary valve.
In operative technique, two patch techniques to the main pulmonary artery (PA) and right ventricular outflow tract was done in 5(10%) cases, open pulmonary valvotomy in 18 (36%) cases while monocusp patch from the native pericardium was applied to the pulmonary valve in 10 (20%) cases. Limited transannular pulmonary valvotomy was done in 2 (4%) cases while in 15(30%) cases normal pulmonary valve only infundibulactomy was done.

Results: About 3 (6%) patients died due to septicemia after having pulmonary valvotomy and MAPCA coiling intotal correction procedure. Bilateral pleural effusion was reported in 10 (20%) and 5 (10%) patients hadascites. Superficial wound infection occurred in 7 (14%) of the patients.

Conclusion: Pulmonary valve securing approach is a significant factor for total correction of TOF.