title: [Treatment of Fallot tetralogy with a transannular patch. Six years follow-up].
abstract: BACKGROUND
  Primary repair of Fallot tetralogy has been performed successfully for the last 45 years. It has low surgical mortality (< 5%), with excellent long-term results. However, there are delayed adverse effects: progressive right ventricular dilation and dysfunction, arrhythmia, and sudden death. In our centre, Fallot tetralogy is the most common form of cyanotic congenital heart disease (including transannular patch) and accounts for 7.5% of all cardiovascular surgical procedures. The mid-term follow-up results are reported.
  
  
  METHODS
  Case series. The study included patients who had complete repair of Fallot tetralogy with transannular patch from January 2000 to December 2009. An analysis was performed on the clinical variables, morbidity and mortality.
  
  
  RESULTS
  There were 52 patients in the study, with mean age 4 ± 2 years. Perioperative mortality in 6 patients, with 5 associated with residual right ventricular obstruction and, 1 associated with further surgery. The survival rate was 88% (46) patients, with a follow-up 75 ± 26 months. Late morbidity occurred in 14, due to right ventricular dysfunction in 11, recurrent distal obstruction in 2, and residual ventricular septal defect in 1. Associated risk factors were severe pulmonary insufficiency (p=0.001); QRS > 160 ms, p=0.001); cardiothoracic > 0.60 index, (p=0.048), and tricuspid regurgitation (p=0.001).
  
  
  CONCLUSIONS
  There was reasonable long-term survival and excellent quality of life after total correction of Fallot tetralogy; however, progressive right ventricular dysfunction requires continuous monitoring, as well as the choice of optimal timing of pulmonary valve replacement.
authors.affiliation: Departamento de Cirugía Cardiotorácica Pediátrica, Unidad Médica de Alta Especialidad, Hospital de Especialidades del Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, México.
authors.forename: Myriam
authors.initials: M
authors.lastname: Galicia-Tornell
authors.affiliation: Departamento de Cirugía Cardiovascular, Hospital Infantil de México Federico Gómez, México, D.F., México.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Reyes-López
authors.affiliation: Departamento de Cirugía Cardiovascular, Hospital Infantil de México Federico Gómez, México, D.F., México.
authors.forename: Sergio
authors.initials: S
authors.lastname: Ruíz-González
authors.affiliation: Departamento de Cirugía Cardiovascular, Hospital Infantil de México Federico Gómez, México, D.F., México.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Bolio-Cerdán
authors.affiliation: Unidad de Investigación Médica en Epidemiologia Clínica, Unidad Médica de Alta Especialidad, Hospital de Especialidades del Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, México.
authors.forename: Alejandro
authors.initials: A
authors.lastname: González-Ojeda
authors.affiliation: Unidad de Investigación Médica en Epidemiologia Clínica, Unidad Médica de Alta Especialidad, Hospital de Especialidades del Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, México. Electronic address: clotilde.fuentes@gmail.com.
authors.forename: Clotilde
authors.initials: C
authors.lastname: Fuentes-Orozco
mesh_terms: D001705:Bioprosthesis; D006348:Cardiac Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000209:etiology; D011664:Pulmonary Valve / Q000601:surgery*; D011665:Pulmonary Valve Insufficiency / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D011788:Quality of Life; D012086:Reoperation; D013771:Tetralogy of Fallot / Q000601:surgery*; D016896:Treatment Outcome; D018497:Ventricular Dysfunction, Right / Q000209:etiology; D014694:Ventricular Outflow Obstruction / Q000209:etiology
keywords: Fallot tetralogy; Parche transanular; Repair; Reparación quirúrgica; Tetralogía de Fallot; Transannular patch