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2013, Number 4

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Rev Med Inst Mex Seguro Soc 2013; 51 (4)

Small infundibulectomy versus ventriculotomy in tetralogy of Fallot

Bojórquez-Ramosa JC

Language: Spanish
References: 20
Page: 438-443
PDF size: 69.68 Kb.


ABSTRACT

Background: the surgical correction of tetralogy of Fallot (TOF) is standardized on the way to close the septal defect, but differs in the way of expanding the right ventricular outfl ow tract (RVOT). The aim was to compare the early postoperative clinical course of the RVOT obstruction enlargement in classical ventriculotomy technique and the small infundibulectomy (SI).
Methods: it was done an analysis of the database of pediatric heart surgery service from 2008 to 2011. Patients with non-complex TOF undergoing complete correction by classical ventriculotomy or SI were selected. Anova, χ2 and Fisher statistical test were applied.
Results: the data included 47 patients, 55 % (26) male, mean age 43 months (6-172), classical ventriculotomy was performed in 61.7 % (29), this group had higher peak levels of lactate (9.07 versus 6.8 mmol/L) p = 0049, greater magnitude in the index bleeding/kg in the fi rst 12 hours (39.1 versus 20.3 mL/kg) p = 0.016. Death occurred in 9 cases (31.03 %) versus one (5.6 %) in the SI group with p = 0.037; complications exclusive as acute renal failure, hemopneumothorax, pneumonia, permanent AV-block and multiple organ failure were observed.
Conclusions: morbidity and mortality was higher in classical ventriculotomy group in comparison with SI. This is possibly associated with higher blood volume.


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