Jornal de reabilitação cardíaca e pulmonar

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Intracardiac Repair for TOF Below 1 Year of Age-Outcome Analysis and Review of Literature

Vikram Halder, Shyam Kumar Singh Thingnam, Harkant Singh, Sachin Mahajan, Rohit Kumar Manoj, Anand Kumar Mishra, Soumitra Ghosh, Sujitha Reddy Karri, Krishna Prasad, Vidur Bansal

Introduction: Most of the advanced centers perform intracardiac repair for tetralogy of fallot between 3-6 months. We had done this thesis to analyze outcome of TOF operated at 1 year or below in our institute.

Materials method: All patients underwent intracardiac repair for TOF below one year of age between 2020 Jan to 2021 June were included in our study. TOF with other associated anomalies and patients not willing to participate in the study were excluded from our study. Ethical clearance was taken from our institutional ethics committee. After history taking and physical examination CXR, ECG and 2 D echocardiography were done in all patients. All patients underwent intracardiac repair according to standard procedure. Immediately after the operation, vasoactive inotropic score, hours of ventilation, hours of inotropic support, intensive care unit stay, hospital stay, and in-hospital mortality was collected. All patients were followed up at 15 days intervals for the first two months, then once monthly for six months, then six monthly forever.

Result: Total 16 patients of tetralogy of Fallot were operated below one year of age. Mean age was 8.69 months and mean weight of the patients was 3.22 kg. Most common presenting symptom was cyanosis (100%) On echocardiography TOF with PS, TOF with PA and TOF with APV was present in 87.5%, 6.25% and 6.25% of the patients.68.75% of the patients underwent TAP. Median VIS score, hours of ventilation, hours of inotropic support, NIV requirement were 25.5,84 hours, 100 hours, and 72 hours consecutively. Mean ICU and hospital stay were 11.81 days and 19.29 days consecutively. Median follow up duration were 9 months and functional status of most of the patients were ROSS I.

Conclusion: Cardiopulmonary bypass time, aortic cross clamp time ,intensive care unit stay and significant residual lesion, which is one of the major determinant of outcome of paediatric cardiac surgery was absent in all our patients. We have to wisely choose the optimal age of repair for accepted outcome.