| Predicted outcome after repair of tetralogy of Fallot by postoperative pressure ratio between right and left ventricle. | |
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MedLine Citation:
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PMID: 16583580 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The surgical management of tetralogy of Fallot (TOF) has continued to evolve and there are now generally excellent early and long-term results following complete repair. OBJECTIVE: To investigate the early results of the authors' current surgical management of TOF by assessing the perioperative and early to intermediate follow-up period. The authors paid particular attention to the post-operative ratio of right ventricular to left ventricular systolic pressure (RVSP/LVSP), focusing on the presence of low cardiac output, intensive care unit (ICU) stay, prolonged of inotropic support and ventilation support time. STUDY DESIGN: Retrospective study. MATERIAL AND METHOD: Between June 2002 and August 2004, 31 consecutive patients underwent complete repair of TOF. Their mean age was 7.7 +/- 5.1 years (range, 2.9 to 25.3). A previous palliative shunt had been performed in 14 (45.2%) patients. Twenty-three patients (74.2%) were in NYHA FC II. Mean hematocrit and oxygen saturation were 50.9 +/- 10.25% and 80.5 +/- 8.6%, respectively. Mean preoperative ratio of RVSP/LVSP was 1.1 +/- 0.15. The operative approach was transatrial/transpulmonary, and 17 (54.8%) patients required a transannular patch. An extracardiac valve conduit was necessary in 3 (9.7%) patients with pulmonary atresia. RESULTS: There were no operative or late deaths. Two cases were reoperated from cardiac tamponade. Mean postoperative ratio of RVSP/LVSP was 0.53 +/- 0.16. Median ICU and hospital stays were 2.2 and 11 days, respectively. Presence of low cardiac output and prolonged inotropic support were significantly (P < 0.05) related to a RVSP/LVSP ratio of more than 0.5. At median follow-up of 6 months, 29 (93.5%) patients were asymptomatic and all patients were free of significant residual lesion. CONCLUSION: The authors' early results in complete repair of TOF patients are acceptable with a low incidence of morbidity. A postoperative RVSP/LVSP ratio of more than 0.5 was significantly associated to adverse outcome. Late complications may, however, develop, and long term follow-up for early detection of any such complications is essential. |
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Authors:
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Voravit Chittithavorn; Chareonkiat Rergkliang; Apirak Chetpaophan; Prasert Vasinanukorn; Somkiat Sopontammarak; Worakan Promphan |
Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Journal of the Medical Association of Thailand = Chotmaihet thangphaet Volume: 89 ISSN: 0125-2208 ISO Abbreviation: J Med Assoc Thai Publication Date: 2006 Jan |
Date Detail:
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Created Date: 2006-04-04 Completed Date: 2006-05-10 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 7507216 Medline TA: J Med Assoc Thai Country: Thailand |
Other Details:
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Languages: eng Pagination: 43-50 Citation Subset: IM |
Affiliation:
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Division of Cardiovascular Thoracic Surgery, Department of Surgery, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand. cvoravit@medicine.psu.ac.th |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Cardiac Output, Low / complications Child Child, Preschool Female Heart / physiopathology* Heart Ventricles / physiopathology Humans Male Postoperative Complications Postoperative Period Retrospective Studies Tetralogy of Fallot / physiopathology, surgery* Ventricular Pressure / physiology* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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