Comparison of late clinical status between patients with different hemodynamic findings after repair of tetralogy of Fallot |
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| Authors: | D Chen J H Moller |
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| Affiliation: | 1. Department of Pediatrics, University of Minnesota Hospitals Minneapolis, Minn., USA.;2. Department of Internal Medicine, University of Minnesota Hospitals Minneapolis, Minn., USA.;1. College of Agronomy, Inner Mongolia Agricultural University, Hohhot 10010, PR China;2. Ottawa Research and Development Centre, Science and Technology Branch, Agriculture and Agri-Food Canada, Ottawa, ON K1A 0C6, Canada;1. Department of Neurosurgery, Harvard Medical School, Brigham and Women''s Hospital, Boston, Massachusetts, USA;2. Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina, USA;1. Division of Cardiology, The Children’s Hospital of Philadelphia, Suite 8NW90, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA;2. Division of Cardiovascular Medicine, The Hospital of the University of Pennsylvania, Perelman School of Medicine at the University of Pennsylvania, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA;3. Philadelphia Adult Congenital Heart Center, The Children’s Hospital of Philadelphia, Perelman Center for Advanced Medicine, Penn Medicine, 3400 Civic Center Boulevard, 2nd Floor East Pavilion, Philadelphia, PA 19104, USA;1. Section of Cardiology, University of Manitoba, Winnipeg, Manitoba, Canada;2. Division of Cardiology, University of Toronto, Toronto Congenital Cardiac Centre for Adults, Toronto General and Mount Sinai Hospitals, Toronto, Ontario, Canada;3. Division of Cardiothoracic Surgery, Toronto General Hospital and Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada;4. Canada Institute for Clinical and Evaluative Sciences, Toronto, Ontario, Canada |
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| Abstract: | Long-term results and postoperative hemodynamic findings were reviewed in 144 cases of tetralogy of Fallot. A correlation was found between the late clinical status of patients and the postoperative hemodynamic findings. The mortality in our series of patients followed for 10 years was 6.25%. Each of the deaths occurred in the group with unsatisfactory postoperative hemodynamic findings. An ideal late clinical result can be anticipated in most patients with excellent or satisfactory postoperative hemodynamic findings. The greater the deviation from normal hemodynamic findings, the worse the prognosis. From the excellent group to the unsatisfactory group, the incidence of late ideal result decreased from 95% to 61.1%, while the incidence of poor result increased from 0% to 27.8%. Among various factors in patients in the unsatisfactory hemodynamic group, right ventricular outflow tract obstruction seems to have the worst late result. A large right ventricular-pulmonary artery pressure gradient was noted in three of four who died suddenly. The late result of patients with a small shunt (pulmonary blood flow/systemic blood flow less than 2) seems acceptable; the decision to reoperate in these patients should be made very cautiously. |
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