title: Severe mitral regurgitation after intracardiac repair of tetralogy of Fallot: a rare complication and management.
abstract: Tetralogy of Fallot (TOF) with additional ventricular septal defect (VSD) forms a difficult surgical subset. Commonly, additional VSD is in the muscular septum and direct visualization may be difficult during surgical repair especially in arrested heart. Consequently, direct closure of these defects is performed based upon preoperative imaging and/or intraoperative transoesophageal echocardiogram. We hereby report an unforeseen occurrence of traumatic acute severe mitral regurgitation after TOF repair possibly during closure of additional muscular VSD. We discuss the possible mechanism of this unprecedented complication, which was promptly diagnosed and managed with good surgical outcomes.
authors.affiliation: Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Dhananjay
authors.initials: D
authors.lastname: Malankar
authors.affiliation: Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Vinitha Viswambharan
authors.initials: VV
authors.lastname: Nair
authors.affiliation: Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Saurabh Kumar
authors.initials: SK
authors.lastname: Gupta
authors.affiliation: Department of Cardiac Anaesthesia, Cardio Thoracic Centre, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Sambhunath
authors.initials: S
authors.lastname: Das
authors.affiliation: Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, India airanbalram@gmail.com.
authors.forename: Balram
authors.initials: B
authors.lastname: Airan
mesh_terms: D000208:Acute Disease; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002675:Child, Preschool; D018618:Echocardiography, Doppler, Color; D005260:Female; D006345:Heart Septal Defects, Ventricular / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D058386:Mitral Valve Annuloplasty; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D012086:Reoperation; D012720:Severity of Illness Index; D013536:Suture Techniques / Q000009:adverse effects; D013771:Tetralogy of Fallot / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome
keywords: Mitral regurgitation; Tetralogy of Fallot; Ventricular septal defect