Pre-and Post-Operative Evaluation of Tetralogy of Fallot

Lee, K S; Lee, D W; Suh, H S; Lee, H J; Park, J M

Abstract

A clinical observation was carried out on 44 patients with tetralogy of Fallot, who had been admitted to the Hanyang University Hospital from August 1975 to July 1982, and the following results were obtained. 1) The frequency of associated congenital cardiovascular anomalies was 40.9% and atrial septal defect was the most common anomaly(27.3%). 2) The type of surgical intervention consisted of 44 procedures with 10 palliative surgery(Waterston operation 1, modified Blalock - Taussig operation 8, infundibulectomy 1) and 34 total correction. Eleven of 34 patients with total correction expired(mortality rate, 32.4%). 3) Pericardial right ventricular outflow patch had been used in nearly all cases(33/34) and valved conduit was required in one remaining patient with main pulmonary artery atresia. 4) Pressure gradient betwen right ventricle and pulmonary artery, and pressure ratio between right ventricle and left ventricle were hight in operative death groups than in survivor groups. 5) Cardiothoracic ratio and pulmonary vascular marking were increased after cardiac surgery. 6) Most of deaths occured within second day of operation by cause of low cardiac output. 7) Surgical mortality were higher in groups of associated congenital cardiovascular anomalies and of unfavorable pulmonary vascular structures. No difference of surgical mortality betwen infundibular patch and transanular patch were no ticed. 8) Early and late intraventricular conduction disturbances after total correction were right bundle branch block(50.5%, 52.6%), right bundle branch block with left anterior hemiblock(18.2%, 26.3%), and transient complete AV block(9.1%, 0%).