Document Detail


Effect of transannular patching on outcome after repair of tetralogy of Fallot.
MedLine Citation:
PMID:  2596914     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Among 814 patients undergoing repair of tetralogy of Fallot with pulmonary stenosis between 1967 and May 1986, transannular patching in the current era was a weak risk factor for death early postoperatively (predicted 30-day mortality, 4% with a transannular patch and 1.4% without) and is not a risk factor for instantaneous risk of death late postoperatively (predicted 20-year survival including early death, 94% with a transannular patch and 96.5% without). Ninety-six percent of surviving patients were in New York Heart Association functional class I at last follow-up, and the slight decline in this percentage as the interval between operation and last follow-up lengthened could have been due to chance alone (p = 0.24) and was no different in patients with a transannular patch. Transannular patching was a risk factor for reoperation for pulmonary regurgitation late postoperatively, but only a 7% incidence within 20 years is predicted when mild residual stenoses are beyond the patch: the incidence rises to about 20% with important distal stenoses. Inferences from the study are relevant to the indications for transannular patching and insertion of allograft semilunar valves at the time of repair.
Authors:
J K Kirklin; J W Kirklin; E H Blackstone; A Milano; A D Pacifico
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  48     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  1989 Dec 
Date Detail:
Created Date:  1990-01-19     Completed Date:  1990-01-19     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  783-91     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, University of Alabama, Birmingham School of Medicine and Medical Center 35294.
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MeSH Terms
Descriptor/Qualifier:
Child
Follow-Up Studies
Humans
Postoperative Period
Pulmonary Valve / surgery*
Pulmonary Valve Stenosis / surgery*
Reoperation
Risk Factors
Survival Analysis
Survival Rate
Tetralogy of Fallot / mortality,  surgery*
Time Factors

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


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