Surgical repair of tetralogy of fallot in patients under age of 8 months with pulmonary stenosis: A single centre experience

Background: Following corrective surgery in infancy/childhood for tetralogy of Fallot (TOF) or its variants, patients may eventually require pulmonary valve replacement (PVR). Debate remains over which valve is best. We compared outcomes of the Medtronic Freestyle valve with that of the pulmonary allograft valve following PVR. Methods: A retrospective study was undertaken from a single surgical practice of adult patients undergoing elective PVR between April 1993 and March 2017. The choice of valve was at the surgeon’s discretion. There was a trend toward the almost exclusive use of the more readily available Medtronic Freestyle valve since 2008. Results: One hundred fifty consecutive patients undergoing 152 elective PVRs were reviewed. Their mean age was 33.8 years. Ninety-four patients had a Medtronic Freestyle valve, while 58 had a pulmonary allograft valve. There were no operative or 30-day mortality. The freedom from reintervention at 5 and 10 years was 98% and 98% for the pulmonary allograft and 99% and 89% for the Medtronic Freestyle. There was no significant difference in the rate of reintervention, though this was colored by higher pulmonary gradients across the Medtronic Freestyle despite its shorter follow-up. Conclusions: Pulmonary valve replacement following previous surgical repair of TOF or its variants was found to be safe with no significant differences in mortality or reintervention between either valve. Although the Medtronic Freestyle valve had a greater tendency toward pulmonary stenosis, additional follow-up is needed to further document its long-term outcomes.

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Contemporary Results Following Surgical Repair of Acute Type A Aortic Dissection (AAAD): A Single Centre Experience

Heart Lung and Circulation ◽

10.1016/j.hlc.2010.05.009 ◽

2010 ◽

Vol 19 (11) ◽

pp. 665-672 ◽

Cited By ~ 14

Author(s):

Andrew J.M. Campbell-Lloyd ◽

Julie Mundy ◽

Nigel Pinto ◽

Annabelle Wood ◽

Elaine Beller ◽

...

Keyword(s):

Aortic Dissection ◽

Surgical Repair ◽

Type A ◽

Acute Type ◽

Single Centre ◽

Type A Aortic Dissection ◽

Single Centre Experience

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Tetralogy of Fallot with absent pulmonary valve syndrome: A 34-year African single centre experience

SA Heart ◽

10.24170/15-2-3046 ◽

2018 ◽

Vol 15 (2) ◽

Author(s):

Vijay Mammen ◽

Paul Adams ◽

Hopewell Ntsinjana ◽

Antoinette Cilliers

Keyword(s):

Tetralogy Of Fallot ◽

Pulmonary Valve ◽

Absent Pulmonary Valve ◽

Single Centre ◽

Single Centre Experience ◽

Absent Pulmonary Valve Syndrome

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948 Visceral Artery Aneurysms- A Single Centre Experience Over 6 Years

British Journal of Surgery ◽

10.1093/bjs/znab134.338 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

S Zaki ◽

M Ashrafi ◽

A Balakrishnan

Keyword(s):

Medical Records ◽

Surgical Repair ◽

Surgical Intervention ◽

Visceral Artery ◽

National Guidelines ◽

Single Centre ◽

Endovascular Interventions ◽

Single Centre Experience ◽

Visceral Artery Aneurysms

Abstract Introduction The incidence of visceral artery aneurysms (VAA) varies from 0.01-0.1%. They are significant with a mortality risk of up to 75% if ruptured. Given there are no national guidelines we decided to conduct this study to assess the management of VAA in our trust and recommend local guidelines. Method We retrospectively identified patients who had a detected VAA between April 2014 and April 2020. Medical records and relevant imaging were reviewed in detail. MDT outcomes and subsequent mortalities noted. Results We identified 62 VAA in 59 patients (23 male), median age 65 years, and mean diameter 18.1 mm. 95 % were detected on CT, the indication was mostly malignancy. MDT outcomes were to continue surveillance for 43 patients with yearly scans, 5 patients had primary surgical repair, 7 patients had endovascular interventions, 1 patient had primary endovascular intervention that failed and required surgical intervention. 7 patients were discharged from follow up due to age and size (12 mm) or VAA completely thrombosed. Conclusions In our unit decisions to intervene were based on size > 20mm, rapid increase in size on surveillance, the presence of portal hypertension or possibly the patients’ young age. There were no mortalities linked to VAA.

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Three steps approach for preoperative evaluation of tetralogy of Fallot patients: role of 128 MDCT

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-021-00418-z ◽

2021 ◽

Vol 52 (1) ◽

Author(s):

Sherif Abd El Fattah Moustafa ◽

Manar Mansour Hussein ◽

Amina Ahmed Sultan ◽

Maha Mohamed Zaki Bilal ◽

Mohamed Adel Fetoh El Gamal ◽

...

Keyword(s):

Tetralogy Of Fallot ◽

Surgical Repair ◽

Pulmonary Stenosis ◽

Preoperative Evaluation ◽

Diagnostic Tools ◽

Associated Anomalies ◽

Complete Evaluation ◽

Diagnostic Modality ◽

Valvular Stenosis ◽

Congenital Cyanotic Heart Disease

Abstract Background Tetralogy of Fallot is the most common congenital cyanotic heart disease. Advances in surgical repair recently facilitate survival of the affected patients into adulthood with good quality of life. Despite imaging plays crucial role in diagnosis of TOF patients, no single diagnostic modality suffices for complete evaluation of TOF. Thus, different diagnostic tools should be used alone or in combination according to patient’s clinical question. This study aims to find out the agreement between the echocardiography and MDCT in evaluation of TOF patients prior to surgical repair. Results Three-step approach used in scanning TOF patients. Firstly, classic TOF findings, MDCT was comparable to echocardiography in overriding aorta (k = 0.6), VSD (k = 0.8), RVH (k = 0.4), and sub valvular pulmonary stenosis (k = 0.6). Echocardiography is superior to MDCT in evaluation of valvular stenosis (k = 0.4). MDCT was superior to echocardiography in supravalvular pulmonary stenosis. Secondary, surgical relevant findings, McGoon ratio calculated in 94.2%, small and major APCs in 45.5% and 28.5% respectively, PDA in 35% and anomalous coronary artery in 5.1%. Thirdly, other TOF-associated anomalies, common: ASD (34.3%) and RAA (28.3%), and persistent LSVC (10.3%). Uncommon: situs ambiguous (2.5 %), PAPVR (1.2%), and IVC anomalies (3.8%). MDCT was superior to echocardiography in surgical relevant findings and other TOF-associated anomalies. Conclusion MDCT is a crucial imaging tool for extra cardiac evaluation of TOF patients prior to surgical repair.

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