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Titolo:
Early postoperative results after total correction of tetralogy of Fallot in older patients: Is primary repair always justified?
Autore:
Shirazi, MAN; Ghavanini, AA; Sajjadi, S;
Indirizzi:
Shiraz Univ Med Sci, Sch Med, Dept Surg, Cardiac Surg Div, Shiraz, Iran Shiraz Univ Med Sci Shiraz Iran pt Surg, Cardiac Surg Div, Shiraz, Iran Shiraz Univ Med Sci, Ctr Res Consultat, Shiraz, Iran Shiraz Univ Med Sci Shiraz Iran ed Sci, Ctr Res Consultat, Shiraz, Iran
Titolo Testata:
PEDIATRIC CARDIOLOGY
fascicolo: 3, volume: 22, anno: 2001,
pagine: 238 - 241
SICI:
0172-0643(200105/06)22:3<238:EPRATC>2.0.ZU;2-1
Fonte:
ISI
Lingua:
ENG
Soggetto:
FOLLOW-UP; SURGICAL-MANAGEMENT; SEPTAL-DEFECT; MORTALITY; SURVIVAL;
Keywords:
tetralogy of Fallot; surgery; treatment outcome;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
22
Recensione:
Indirizzi per estratti:
Indirizzo: Shirazi, MAN POB 71345-1667, Shiraz, Iran POB 71345-1667 Shiraz IranPOB 71345-1667, Shiraz, Iran
Citazione:
M.A.N. Shirazi et al., "Early postoperative results after total correction of tetralogy of Fallot in older patients: Is primary repair always justified?", PEDIAT CARD, 22(3), 2001, pp. 238-241

Abstract

The objective of this study was to compare early postoperative results in primary vs 2-stage repair of tetralogy of Fallot in patients operated on after 5 years of age. Eighty-four patients with tetralogy of Fallot were studied, who were more than 5 years of age and who were repaired in one center by one surgeon. Hospital death and ratio of right-to-left ventricle pressure after correction were compared between the primary and the 2-stage groupsas early outcome indices. Overall hospital mortality was 11.9% (10/88). There were 9 (18.4%) hospital deaths in the primary and 1 (2.9%) in the 2-stage group. Mortality was significantly higher in the primary group (p = 0.04using the 2-tailed Fisher's exact test; relative risk = 6.43; 95% CI = 0.85-48.46). The mean +/- standard deviation (SD) for RV/LV ratio was 0.51 +/-0.13. It was 0.61 +/- 0.11 in patients who died and 0.49 +/- 0.12 in patients who lived (p = 0.01 using the 2-tailed t-test). RV/LV ratio was not significantly different between either group. In the 2-stage group, there was a small inverse correlation between the time interval and the RV/LV ratio (correlation coefficient = -0.235). The TAP group had a statistically significant lower time interval between shunt and total correction than the RVOT-P group (p = 0.02 using 2-tailed t-test). Older patients generally do better on 2-stage repair, because of their age. A long period of low pulmonary blood flow has induced unbalanced ventricles and exaggerated RVOTO for thesepatients because of muscle hypertrophy. In such patients, shunting will prepare the left ventricle for accepting the extra blood volume that will reach the left ventricle after total correction.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/05/20 alle ore 23:11:28