International Journal of Cardiovascular ResearchISSN: 2324-8602

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Clinical outcomes of complete repair of TOF following RVOT stenting versus BT shunt palliation


Mohsen Sedighi

Iran University of Medical Science, Iran

: Int J Cardiovas Res

Abstract


Tetralogy of Fallot (TOF) is among the first congenital heart disease required primary intervention during the newborn period. We assessed the effect of right ventricular outflow tract (RVOT) stenting versus Blalock-Taussig (BT) shunt palliation on subsequent TOF surgical repair. A total of 15 infants with TOF underwent complete repair surgery in our center. Primary RVOT stenting was performed in 7 symptomatic infants, and 8 infants underwent BT shunt prior to surgery. Data on sequential patients who underwent corrective surgery were collected and reviewed retrospectively from their surgical, echocardiographic, and catheterization data. Our population consists of 8 males and 7 females. The mean age and weight of infants at the time of surgery were 11.66±2.49 months and 9.43±2.16 kg, respectively. The median diameter of RPA at palliation was 3.1±0.46 mm (Z-Score range -4.62 to -2.01) that increased to 4.5±0.42 mm (Z-Score range -1.61 to -0.01) at surgery (P=0.001). Likewise, the median diameter of LPA at palliation was 2.7±0.38 (Z-Score range -4.74 to -2.24) increased to 3.2±0.31 (Z-Score range -3.21 to -1.38) (P=0.001). Majority of infants (77.5%) in RVOT stenting group experienced TAP at surgical repaired, while two infant in BT shunt group (25%) received TAP (P=0.019). There were not seen any significant differences between groups regarding postoperative complication, RV failure, aortic clamp, CPB time and ICU stay. Our findings showed that RVOT stenting is superior to BT shunt in high risk infants with low age and weight especially tet spells. More importantly, RVOT stent provide remarkable improvement of pulmonary blood flow and growth of the both branches of PA allowed elective surgical repair in future. However, TAP requirement is not inevitable in majority of cases at surgery.

Biography


Mohsen Sedighi is a PhD candidate of Neuroscience at Iran University of Medical Sciences and member of IBRO. He has been in collaboration with Chamran Heart Center since 2010 resulted in published several papers related to Congenital Heart Surgery in reputed journals and participated in several international cardiovascular congresses.

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