Surgical Risk for Adult with Tetralogy of Fallot
Abstract
Background. The beneficiaries of successful pediatric cardiac surgery and cardiology increases surgical treatment in the adult population with congenital heart disease. Adults patient with Tetralogy of Fallot (TOF) will need surgery either reoperative, palliative or more commonly reparative by the time they come. Many of them face the prospect of further operations, arrhythmias, complications and if managed inappropriately will increase risk of heart failure and premature death. This study presents the early surgical results of adult TOF.Methods and results.Data were reviewed retrospectively related to the hospital course of TOF adult patients (age > 17 years) from June 1, 1998 to December 30, 2006 who require surgical treatment in National Cardiac Center - Harapan Kita, Indonesia. Most of the operations were corrective procedures (20 patients, 66.7%), followed by palliative procedures (6 patients, 20%), and reoperations (4 patients, 13.3%). Mean age at surgery was 20.87+5.49 years. There were no hospital mortality in the primary corrective group, one death (16.7) in the palliative group related to poor left ventricular function, and one death (25%) in the reoperation group related to perioperative bleeding. Follow up data of 11.73+17.68 months duration were available in 28 of 30 patients (93%) who were discharged home. Overall survival probability is higher for corrective procedures than palliative and reoperative procedures.
Conclusions. Surgical treatment of TOF in adult patients proved quite save and beneficial.
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References
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Shimazaki Y, Blackstone EH, Kirklin JW: The natural history of isolated congenital pulmonary valve incompetence; surgical implications. J Thorac Cardiovasc Surg 32;257,1984
Daenen W, Lacour-Gayet F, Abert T, Comas JV, Daebritz SH, DiDonato R, Hamilton JR, Lindberg H, Maruszewski B, Monro J. EACTS congenital heart disease committee. Optimal structure of a congenital heart surgery department in Europe. Eur J Cardiothorac Surg 2003; 24(3):343-51.
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Mavroudis C (Chairman) and Congenital Database Subcommittee: Backer CL, Bove E, Burke RP, Cameron D, Drinkwater DC, Edwards FH, Grover FL, Hammon JW Jr, Jacobs JP, Kron IL, Mayer JE, Myers JL, Ring WS, Siewers RD, Szarnicki RJ, Watson DC Jr, Data analyses of the society of Thoracic Surgeons National Congenital Cardiac Surgery Database 1994-1997. Summit Medical, Minnetonka, MN; September 1998.
Khodla R, Verna DD, Kapur A, Khosla S. Efficient source data verification. Indian Journal of Pharmacology 2000; 32:180-6
WHO guidelines for Good Clinical Practice for Trial on Pharmacoceutical Products; 1994
Bohdan Maruszewski, Francois Lacour-Gayet, James L. Monro, Bruce E. Keogh, Zdislaw Tobota, Andrzej Kansy. An attempt at data verification in the EACTS Congenital Database. Eur J of Cardiothorac Surg 2005; 28(3):400-6
Michael A. Gatzoulis. Adult congenital heart disease: education, education, education. Nature Clinical Practice cardiovascular Medicine 2006 vol 3 No.1.
Joseph W. Rossano, E. O. Brian Smith, CharlesD. Fraser, E. Dean McKenzie et al. Adults undergoing cardiac surgery at Children’s Hospital: An analysis of perioperative morbidity. Ann Thorac Surg 2007; 83:606-612.
Presbitero P, Prever SB, Contrafatto I, Morea M. Results of total correction of TOF performed in adults: updated in 1996. Ann Thorac Surg.
M. Elizabeth Brickner, L. David Hillis, Richard A. Lange. Congenital hearts disease in adults. 2o of two parts.New England J of Med. Feb 3 2000 No.5 Vol 342:334-342.
Shimazaki Y, Blackstone EH, Kirklin JW: The natural history of isolated congenital pulmonary valve incompetence; surgical implications. J Thorac Cardiovasc Surg 32;257,1984
Daenen W, Lacour-Gayet F, Abert T, Comas JV, Daebritz SH, DiDonato R, Hamilton JR, Lindberg H, Maruszewski B, Monro J. EACTS congenital heart disease committee. Optimal structure of a congenital heart surgery department in Europe. Eur J Cardiothorac Surg 2003; 24(3):343-51.
Williams WG, McCrindle BW. Practical experience with databases for congenital heat disease: a registry versus academic database. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2002; 5(1):132.
Mavroudis C (Chairman) and Congenital Database Subcommittee: Backer CL, Bove E, Burke RP, Cameron D, Drinkwater DC, Edwards FH, Grover FL, Hammon JW Jr, Jacobs JP, Kron IL, Mayer JE, Myers JL, Ring WS, Siewers RD, Szarnicki RJ, Watson DC Jr, Data analyses of the society of Thoracic Surgeons National Congenital Cardiac Surgery Database 1994-1997. Summit Medical, Minnetonka, MN; September 1998.
Khodla R, Verna DD, Kapur A, Khosla S. Efficient source data verification. Indian Journal of Pharmacology 2000; 32:180-6
WHO guidelines for Good Clinical Practice for Trial on Pharmacoceutical Products; 1994
Bohdan Maruszewski, Francois Lacour-Gayet, James L. Monro, Bruce E. Keogh, Zdislaw Tobota, Andrzej Kansy. An attempt at data verification in the EACTS Congenital Database. Eur J of Cardiothorac Surg 2005; 28(3):400-6
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How to Cite
Wilamarta, K., Fakhri, D., & Rachmat, J. (1). Surgical Risk for Adult with Tetralogy of Fallot. Indonesian Journal of Cardiology, 28(3), 197-202. https://doi.org/10.30701/ijc.v28i3.241
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