Short-term outcomes following total correction of tetralogy of fallot in adult patients

J Cardiothorac Surg. 2023 Nov 14;18(1):324. doi: 10.1186/s13019-023-02411-1.

Abstract

Objectives: Tetralogy of Fallot (TOF) is a common congenital heart disease which should be corrected. The recommended time for the Tetralogy of Fallot Total Correction (TFTC) surgery is during the infancy for the possible difficulties during the surgery and the related issues. However, sometimes TOF is diagnosed and managed during the adulthood.

Methods: This study is a descriptive and retrospective one which included all patients who underwent TFTC at the age of 15-year and older in 10 years (between the years 2010 and 2020) to identify short-term (in-hospital mortality, ICU stay, postoperative bleeding, respiratory complications after the surgery such as pulmonary edema, pneumonia, etc.) and one-year (left ventricle ejection fraction (LVEF), right ventricle (RV) ejection fraction, the severity of tricuspid and aortic regurgitation after surgery) outcomes. All data were taken from medical records at Rajaie Cardiovascular Medical and Research Center. Data were analyzed using SPSS 22.

Results: 94 patients with the mean ± SD age of 26.7 ± 9.6 years were enrolled. Most of them were male (59.6%) (P-value: 0.009). In-hospital mortality in our study were 5.3%. Tricuspid regurgitation (TR) was significantly resolved after the surgery (P-value: 0.006). Of 17 (18.1%) patients with small or hypoplastic pulmonary artery (PA) branches, 14 patients had acceptable PA branch size after surgery.

Conclusion: TFTC at an older age is safe with acceptable results. Age is not a contraindication for TFTC and surgery should be recommended if the patients are diagnosed with TOF in adulthood. Also, the TOF diagnosis should be considered in adult patients with suspicious signs and symptoms.

Keywords: Adulthood; Complication; Congenital Heart Disease; Mortality; Outcome; Tetralogy of Fallot; Tetralogy of Fallot Total correction.

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Humans
  • Male
  • Retrospective Studies
  • Stroke Volume
  • Tetralogy of Fallot* / complications
  • Tetralogy of Fallot* / surgery
  • Tricuspid Valve Insufficiency* / etiology
  • Ventricular Function, Left