Transatrial approach for total tetralogy of Fallot TOF correction : analysis of 24 cases

Abstract EN

Abstract: Background: Tetralogy of Fallot TOF is the most common cause of congenital cyanotic heart disease.

It is the most common congenital lesion that is likely to result in survival to adulthood and encountered in adult after repair.

Tetralogy of Fallot comprises around 7.5 % of all congenital heart diseases in Iraq.

Objective: The aim of this study is to analyse the transatrial strategy for total correction of tetralogy of Fallot TOF.

Methods: Cross-sectional study was done during the period between 2012-2014 for twenty-four patients that admitted to Ibn Al-Bitar hospital in Baghdad with amenable TOF pathology for transatrial repair.

Results: Twenty-four patients, 16 were males and 8 were females.

Ages ranged from 2-31 years.

There was no early or late postoperative mortality in this review for follow-up period ranged from 6 – 24 months.

The early and late postoperative echocardiography data in regard to pulmonary and tricuspid regurgitation and right ventricle RV function were delineated.

Normal pulmonary valve (62.5%, 58.3%), mild pulmonary regurgitation (29.2%, 37.5%), moderate pulmonary regurgitation (8.3%, 4.2%).

Normal tricuspid valve (75%, 70.8%), mild tricuspid regurgitation (20.8%, 20.8%), moderate tricuspid regurgitation (4.2%, 8.3%) respectively.

No severe pulmonary or tricuspid regurgitation was reported.

Postoperative RV function was normal in (87.5%, 83.3%), mild RV dysfunction in (8.3%, 12.5%), moderate RV dysfunction in (4.2%, 4.2%) respectively.

No severe RV dysfunction was reported.

The mean RVOT pressure gradient was 36.8 mmHg.

This gradient decreased on follow-up echocardiography, mean 24.5 mmHg.

P values were less than 0.05%.

Conclusion: The transatrial approach is a feasible technique for total repair of TOF in adequate pulmonary annulus size with satisfactory late postoperative echocardiography performance.

Keywords: Tetralogy of Fallot.

Total correction.

Transatrial repair.