Primary versus staged repair of Fallot with borderline pulmonary artery anatomy

The Cardiothoracic Surgeon

Suzan Bayoumy¹  Basem M. Abdelgawad²  Mahmoud A. Elshafie²  Elatafy E. Elatafy³ 

[1] Cardiology Department, Faculty of Medicine, Tanta University;Cardiothoracic Surgery Department, Faculty of Medicine, Benha University;Cardiothoracic Surgery Department, Faculty of Medicine, Tanta University;

关键词: Tetralogy of Fallot;    McGoon ratio;    Primary Fallot repair;    Blalock-Taussig shunt;   

DOI  :  10.1186/s43057-019-0011-y

来源: DOAJ

【 摘 要 】

Abstract Background Surgical management of tetralogy of Fallot (TOF) can be either with a total primary repair or staged repair. The superiority of one technique over the other is still debatable, especially in developing countries with late presentation and limited resources. The objective of this study was to compare the outcome of patients with tetralogy of Fallot and borderline pulmonary anatomy defined as McGoon ratio between 1.2 and 1.6 who underwent primary versus staged repair. Results The patients were divided into two groups: group A included patients who underwent primary repair (n = 120) and group B included patients who underwent repair after previous modified Blalock-Taussig (MBT) shunt operation (n = 100). Patients in group B were significantly older (11 ± 2.6 vs. 7 ± 3.1 months; p <  0.001) and had higher McGoon ratio (1.61 ± 0.07 vs. 1.5 ± 0.08; p <  0.001). In group B, the total operative time (277 ± 21.3 vs. 232 ± 24.6 min; p <  0.001), cardiopulmonary bypass time (81 ± 13.7 vs. 60 ± 11.2 min; p <  0.001), and ischemic time (64 ± 12 vs. 53 ± 7.1 min; p < 0.001) were significantly higher. There was no difference in postoperative complications between both groups. In-hospital mortality was nine patients (7.5%) in group A and 6 (6%) in group B (p = 0.791). Conclusion Primary repair of tetralogy of Fallot in patients with borderline McGoon ratio is safe with low morbidity and mortality. It has the potential of decreasing hospital stay, cost, and resource utilization of the two-stage repair.

【 授权许可】

Unknown