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jsmc-10024


EARLY AND LATE OUTCOMES IN REPAIRED TETRALLOGY OF FALLOT


Rana Adnan Ahmed *, Aso Faeq Salih **, Najeeb Hassan Mohammed *** and Suhair Nadhim Mahmoud ***


*    Khanqeen General Hospital, Ministry of Health, Iraq.
*    Sulaimani Pediatric Teaching Hospital, Sulaimani, Kurdistan, Iraq. 
*** Department of Physiology, Collage of Medicine, University of Baghdad, Baghdad, Iraq.


Submitted: 4/3/2012; Accepted: 17/6/2012Published 1/12/2012


ABSTRACT


Background  

Tetralogy of Fallot is the most common cyanotic congenital heart disease which needs surgical repair usually during 1st year of life. Numerous early and late complications arise postoperatively such as right ventricular failure, arrhythmias, pulmonary valve and branch stenosis and regurgitation and VSD patch residual leak and dehiscence. The 2D, wave and color Doppler-echocardiography reveal an important tool not only in the diagnosis of children with such disease and its complications, but also in their follow up post operatively in whom further therapy can be provided.

Objective

This study aims to detect an early (within the 1st year) and late (after the 1st year) post surgical repair complications using 2D echo, wave and color Doppler-echocardiography and ventricular performance index. Correlate between type of operation performed and the type, time and severity of the complications that might appear. Find out the percentage, type, onset of post-surgical repair complications.

Patients and Methods

Children and adolescent of either sex suffered with TOF operated upon, or waiting for operation had been subjected to medical history, clinical examination, oxygen saturation, ECG, chest x-ray and Doppler- echocardiography. However, these tests had been done in Sulaimani Pediatric Teaching Hospital/ Pediatric Cardiology Department.

Results

This study shows that there is a significant increase in SpO2 after operation (P-value= 0.0001), RBBB show high incidence in group 2 (P-value = 0.0001), Pulmonary valve regurgitation shows high incidence in group 2 (P-value of (0.0001)), tricuspid regurgitation was also significant (P-value = 0.029), EF shows significant correlation with BSA (P-value = 0.0001) and Z-score of -2.62. MPI of the right ventricle of the two groups show the RVESD show significant finding (P-value = 0.042).

Conclusion

Patients with TOF operated upon are suspected to have several complications that need to be evaluated serially to illustrate their progression and if they need further intervention. The echocardiography is a non invasive, bedside, available and relatively cheap investigation of benefit in assessing these patients and their follow up.

KEYWORDS

Echocardiography, Tetralogy of Fallot, MPI.

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