Hatem AlMasri
King Abdulaziz Medical City, Saudi Arabia
Title: Correction using surgical procedure of tetralogy of fallot with small pulmonary annulus – Can we preserve the valve annulus
Biography
Biography: Hatem AlMasri
Abstract
To determine the outcome of repair of Tetralogy of Fallot (TOF) with small pulmonary annulus by preserving the pulmonary valve.
All consecutive patients (n=41) operated by a single surgeon using the above technique were reviewed. The pulmonary annular size was based on preoperative transthoracic or intraoperative TEE measurement. All patients had pulmonary annular size with Z value of -2 or less.The mean age of the patients were 6.2 years (range from 2 to 23). There were more males to females (26:15). All patients were cyanosed, and 11 were severely cyanosed. Eleven patients had previous Blalock-Taussig shunts, with 2 patients had 2 shunts done. The mean Z score of the pulmonary valve annulus was Z – 4.3 +/- 1.69 mm. All patients had bicuspid and/or dysplastic pulmonary valve. All except 4 patients had infundibular and pulmonary artery augmentation. Post correction mean RV/LV pressure ratio was 0.83. The mean pulmonary valve gradient was 34.8 mmHg. The mean cardiopulmonary bypass time was 143 min and the mean cross-clamp time was 77 min. The mean extubation time was 27 hours and mean ICU stay was 48 hours. All except 4 patients had either none or mild pulmonary regurgitation. There was only 1 mortality in this series. Serial echocardiography was done on follow up. The longest follow up is 3 years and all patients who survive are currently doing well.
The preservation of the pulmonary valve in