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Gian Piero Piccoli
Francesco Musumeci
David I. Hamilton
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Ann Thorac Surg 1982;33:365-373
© 1982 The Society of Thoracic Surgeons

Articles

A Changing Policy for the Surgical Treatment of Tetralogy of Fallot: Early and Late Results in 235 Consecutive Patients

Gian Piero Piccoli, M.D., David F. Dickinson, M.B., Ch.B., M.R.C.P., Francesco Musumeci, M.D., David I. Hamilton, M.B., B.S., F.R.C.S.*

From the Cardiothoracic Surgical Unit, Royal Liverpool Children's Hospital, Liverpool, England.

Accepted for publication April 10, 1981.

* Address reprint requests to Mr. Hamilton, Consultant Cardiothoracic Surgeon, Royal Liverpool Children's Hospital, Myrtle Street, Liverpool L7 7DG, England.

Between February, 1969, and March, 1980, 235 consecutive patients underwent repair of tetralogy of Fallot. Of these, 94 patients were less than 4 years of age, including 40 less than 2 years of age. Previous palliative procedures had been performed in 46 patients. Conservative technique to relieve the right ventricular outflow tract (RVOT) obstruction was employed in 194 patients; transannular approach was performed in the remaining 41. There were 18 hospital deaths (7.6%) and 3 late deaths. The early and late results were significantly related to the ratio of the right ventricular to left ventricular systolic peak pressure after repair. Until 1976, the age of patients at operation constituted an operative risk factor. Since 1977, none of the 17 infants who underwent operation died after the repair. In the overall series, the transannular approach to relieve the RVOT obstruction affected the early mortality and the late results. During the last 3 years, only 1 of the 12 patients who received an aortic homograft monocusp transannular gusset died in the hospital, and the 11 survivors were completely symptom free at follow-up.






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Copyright © 1982 by The Society of Thoracic Surgeons.