title: Early outcome of tetralogy of Fallot repair in the current era of management.
abstract: BACKGROUND
  Traditional use of trans-annular patch (TAP) to release right ventricular outflow tract (RVOT) obstruction during tetralogy of Fallot (TOF) repair may lead to a harmful pulmonary regurgitation. Different approaches have been used to release RVOT obstruction and spare the pulmonary valve (PV) function. In this study, we aim to evaluate the post-operative course of patients who had TOF repair in the current era that emphasizes on protective strategy of releasing RVOT obstruction and preserving PV function.
  
  
  METHODS
  A retrospective study of all TOF cases repaired in our institute between March 2002 and December 2007 was conducted. Cases were classified into two groups; group I included patients that had a TAP, while group II included cases that had simple TOF repair without TAP. Group I was subdivided into two groups, group (A) which include patients who had TAP without a valve. Group (B) includes those who had TAP with a monocuspid valve (Contegra). We compared post-operative care and outcome of all groups.
  
  
  RESULTS
  Eighty-three patients fulfilled the study criteria. There were 64 cases (77%) in group I, and 19 cases (23%) in group II. All children tolerated surgical repair and did well. We observed no statistically significant difference in the post-operative ICU care, complications rates and morbidity between all groups. There was no surgical mortality in all groups.
  
  
  CONCLUSIONS
  Children undergoing TOF repair had excellent short-term outcome with the current protective strategy aiming to spare valvular function, and conserving myocardial function. Applying a monocuspid patch technique did not show clear short-term benefits. Long term follow up is needed to evaluate future difference in different techniques.
authors: King Abdulaziz Medical City, Department of Cardiac Sciences, National Guard Hospital Health Affairs, Riyadh, Saudi Arabia.
authors: Sameh R
authors: SR
authors: Ismail
authors: Mohamed S
authors: MS
authors: Kabbani
authors: Hani K
authors: HK
authors: Najm
authors: Riyadh M
authors: RM
authors: Abusuliman
authors: Mahmoud
authors: M
authors: Elbarbary
keywords: Limited trans-annular patch; Monocuspid patch; Post-operative; Tetralogy of Fallot
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