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Corresponding Author

Eldesouky, Ahmed

Document Type

Original Article

Abstract

Background: Reoperations after tetralogy of Fallot repair is common. This study aimed to report our indications, surgical procedures, and the clinical outcomes of patients undergoing reoperation after surgical correction of TOF. Patient and Methods: We included 40 patients who underwent reoperations after total TOF repair between 2015 and 2019. We included patients who had symptomatic right ventricular failure, patients with residual ventricular septal defect (VSD), right ventricular outflow tract obstruction (RVOTO), and tricuspid or pulmonary valve regurgitation. Results: The median age was 5.5(3.5–12.5) years, and 28(70%) were males. The median age at the time of primary repair was 2 (1-6) years. The end-systolic right ventricular (RV) volume estimated by MRI was 110.33±4.93 cc, and the end-diastolic volume was 208 ±10.08 cc. Twenty-two patients had VSD closure (55%), a transannular patch in 6 patients (15%), and RVOT resection in 14 patients(35%). Pulmonary valve replacement was performed in 6 patients(15%) and tricuspid valve repair in 4 patients (10%). The duration of postoperative mechanical ventilation was 11.5 (9-16.5) hours, and two patients had operative mortality (5%). Two patients (5%) had residual RVOT pressure gradient, and four patients had tiny residual VSD(10%). After six months of follow-up, four patients had moderate pulmonary regurgitation (PR), and four patients had residual VSD (10%). After one year follow-up, two patients had moderate PR(5%). Conclusion: A residual ventricular septal defect is a common indication for reoperation after the primary repair of tetralogy of Fallot. The results of reoperations are good with the accepted incidence of postoperative morbidity and mortality.

Keywords

Tetralogy of Fallot; Reoperations; Residual ventricular septal defects

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