[Results of the surgical treatment of tetralogy of Fallot before 6 months of age. A consecutive series of 62 cases with 49 complete repairs].
From January 1980 to July 1988, 62 infants aged under 6 months with an uncomplicated Tetralogy of Fallot (single ventricular septal defect, normal coronary arteries, no localised pulmonary artery branch stenosis) underwent 64 surgical procedures. The indications for surgery were increasing cyanosis and/or anoxic spells. Fourteen systemic-pulmonary shunts (21.5%), 49 complete repairs (75.4%) and one enlargement of the right ventricular outflow tract and of the main pulmonary artery without closure of the ventricular septal defect, were performed. The results of palliative shunts are preoccupying: cumulative mortality of 36 per cent; high rate of early reoperation for complete repair: 14 per cent. Complete repair was associated with an operative mortality of 14 per cent. Only one child had to be reoperated. There was no late death after complete repair compared with 2 late deaths after shunt. Ultimate results of complete repairs are good. Some risk factors were statistically significantly associated with complete repair: age (2.5 months or less), weight (4,500 g or less), measurements of the pulmonary arteries estimated by the diameter of the right pulmonary artery (5 mm or less). Conversely there was no death in the subgroup of 31 infants aged more than 2.5 months without major pulmonary hypoplasia (diameter of the right pulmonary artery over 3.5 mm). One-stage complete repair give the best short and medium-term surgical results in treatment of uncomplicated Tetralogy of Fallot in infants, irrespective of age and weight providing they have no diminutive pulmonary arteries.(ABSTRACT TRUNCATED AT 250 WORDS)
Gay
F
F
Service de chirurgie cardio-vasculaire et thoracique, hôpital Laennec, Paris.
Guarnera
S
S
Tamisier
D
D
Lecompte
Y
Y
Bical
O
O
Planche
C
C
Vouhe
P
P
Leca
F
F
Kachaner
J
J
Neveux
J Y
JY
D000367:Age Factors; D000714:Anastomosis, Surgical / Q000379:methods* / Q000401:mortality; D001835:Body Weight; D006801:Humans; D007223:Infant; D011184:Postoperative Period; D011651:Pulmonary Artery / Q000002:abnormalities; D012086:Reoperation; D013771:Tetralogy of Fallot / Q000401:mortality / Q000601:surgery*
Résultats du traitement chirurgical appliqué aux tétralogies de Fallot régulières avant l'âge de 6 mois.