Document Detail


Abnormalities of conduction after total correction of Fallot's tetralogy: a prospective study.
MedLine Citation:
PMID:  12073716     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the frequency of post-operative conduction abnormalities in Pakistani patients undergoing total correction for Fallot's Tetralogy. PATIENTS AND METHODS: One hundred and fifteen patients of Fallot's Tetralogy underwent definitive repair between January, 1999 and April, 2000. Their mean age was 12.89 years (range 3-30 years). One hundred nine patients (94.78%) had severe cyanosis and 6 patients (5.21%) were moderately cyanotic due to mild right ventricular outflow tract (RVOT) obstruction. Thirty percent patients required frequent hospital admissions within 6 months before the time of operation due to -hyper-cyanotic spells. The mean haematocrit was 50.83 (range 28-71). The majority of patients were in NYHA class-III (57%) and 45% had previous palliative shunt procedures done. Surgical access was through the RVOT in 90% cases and trans-atrial in 10%. RVOT patch was used in 55.9%, Pulmonary artery patch in 13.5% and trans-annular patch in 17.1% of cases. RESULTS: The mean bypass time was 79.15 min and the mean cross clamp time 51.23 min. Average stay in the intensive care unit was 4.48 days. Twenty-three patients required re-exploration for bleeding. Sixty-nine patients required inotropic support. Fifteen patients had transient heart blocks and two had complete heart block requiring permanent pace-maker. Nineteen patients had various transient arrhythmias which were managed medically. Univariate analysis showed that higher age at operation, low preoperative heart rate, prolonged bypass time, prolonged cross clamp time and presence of patch on pulmonary artery were more common in patients who developed various heart blocks. However, none of these factors had statistical significance or definitive cause-effect relationship with heart blocks. CONCLUSION: With careful surgical technique, total correction of Fallot's tetralogy can be conducted in children and young adults, with a very low risk of conduction abnormalities.
Authors:
A Hussain; A Malik; A Jalal; M Rehman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  JPMA. The Journal of the Pakistan Medical Association     Volume:  52     ISSN:  0030-9982     ISO Abbreviation:  J Pak Med Assoc     Publication Date:  2002 Feb 
Date Detail:
Created Date:  2002-06-20     Completed Date:  2002-07-25     Revised Date:  2008-02-12    
Medline Journal Info:
Nlm Unique ID:  7501162     Medline TA:  J Pak Med Assoc     Country:  Pakistan    
Other Details:
Languages:  eng     Pagination:  77-82     Citation Subset:  IM    
Affiliation:
Department of Cardiac Surgery, National Institute of Cardiovascular Diseases, Karachi.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Arrhythmias, Cardiac / etiology*
Cause of Death
Child
Child, Preschool
Female
Heart Conduction System / physiopathology*
Heart Rate
Humans
Intensive Care Units
Length of Stay
Male
Postoperative Complications / physiopathology*
Tetralogy of Fallot / mortality,  physiopathology,  surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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