Original research

Reoperation after radical correction tetralogy of Fallot: results and prospects

 M.F. Zinkovskyi ¹, A.G. Goryachev ¹, S.O. Dykukha ¹, L.R. Naumova ¹, O.A. Pishchurin ², M.Yu. Atamanyuk ¹, V.M. Hondoga ¹, S.O. Yakubyuk ¹, R.M. Vitovsky ²

1 M.M. Amosov National Institute of Cardiovascular Surgery NAMS of Ukraine, Kyiv, Ukraine

2 Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine

The aim – to present experience, results and prospects of repeated interventions in the remote period after radical correction of tetralogy of Fallot.

Materials and methods. Results of the repeated 65 surgeries in 62 patients after radical correction of tetralogy of Fallot with long-term follow-up for the period from 1981 to 2014 are presented. The interval between the radical tetralogy of Fallot correction and re-operation ranged from 1 month to 30 years (average – 8.54 ± 6.3 years).

Results. Depending on the predominance of one or other complications and its causes we observed: 1) residual defects – 25 (40.4 %) cases; right ventricular dysfunction – 23 (37.0 %) cases; valve pathology – 5 (8.0 %) cases; other rare complications – 9 (14.6 %) cases. In total, 100 complications were identified and eliminated in 62 patients. The most frequent complications that required second surgical correction were: recanalization of ventricular septal defect (36.0 %), right ventricular aneurysm (19.0 %), tricuspid valve insufficiency (13.0 %), the residual obstruction of the outflow tract of the right ventricle (9.0 %), right ventricular dysfunction caused by pulmonary valve insufficiency (6.0 %) and pulmonary trunk aneurysm (5.0 %).

Conclusion. Hospital mortality after surgical correction of long-term complications was 8.0 %. All discharged patients with echocardiographic evaluation revealed a positive dynamics of volume and functional parameters of the right and left ventricles.

Key words: tetralogy of Fallot, radical correction, reoperations, complications, long-term postoperative period.