|Staged repair of tetralogy of Fallot and diminutive pulmonary arteries with a fenestrated ventricular septal defect patch.|
|PMID: 14666015 Owner: NLM Status: MEDLINE|
|OBJECTIVES: Patients with tetralogy of Fallot and diminutive pulmonary arteries are at risk for suprasystemic right ventricular pressure and right ventricular failure after complete repair. We report the short-term outcome and medium-term follow-up after using a fenestrated ventricular septal defect patch as a component of staged repair in selected patients. METHODS: We reviewed 47 patients with tetralogy of Fallot and diminutive pulmonary arteries whose ventricular septal defect patch was fenestrated, either electively or as a rescue technique, at a single institution between 1984 and 2001. RESULTS: Early mortality was 10.6% and occurred only in patients who underwent rescue fenestration. Review of medium-term follow-up (median, 39 months) revealed 4 late deaths; an additional 4 patients experienced right ventricular failure despite fenestration. Most (7/8) of these late events occurred in patients who underwent planned fenestration. Excessive left-to-right shunt through the fenestration developed in only 2 patients. CONCLUSIONS: Fenestrated patch closure of the ventricular septal defect in patients with tetralogy of Fallot and diminutive pulmonary arteries resulted in 10.6% early mortality. Used preemptively in selected patients, this technique is associated with no surgical mortality and a low incidence of excessive left-to-right shunt (4%). Early survivors remain at risk for late death and right ventricular failure despite fenestration.|
|Audrey C Marshall; Barry A Love; Peter Lang; Richard A Jonas; Pedro J del Nido; John E Mayer; James E Lock|
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|Type: Comparative Study; Journal Article|
|Title: The Journal of thoracic and cardiovascular surgery Volume: 126 ISSN: 0022-5223 ISO Abbreviation: J. Thorac. Cardiovasc. Surg. Publication Date: 2003 Nov|
|Created Date: 2003-12-10 Completed Date: 2004-01-14 Revised Date: 2006-11-15|
Medline Journal Info:
|Nlm Unique ID: 0376343 Medline TA: J Thorac Cardiovasc Surg Country: United States|
|Languages: eng Pagination: 1427-33 Citation Subset: AIM; IM|
|Department of Cardiology, Children's Hospital, Boston, MA 02115, USA. Audrey.firstname.lastname@example.org|
|APA/MLA Format Download EndNote Download BibTex|
Cardiac Surgical Procedures / methods*, mortality*
Heart Septal Defects, Atrial / diagnosis, mortality, surgery*
Postoperative Complications / diagnosis, mortality
Tetralogy of Fallot / diagnosis, mortality*, surgery*
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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