SUMMARY
Controversy still persists concerning the optimum management strategy for patients presenting with tetralogy of Fallot. Opinions range the spectrum from those who advocate neonatal complete correction in all patients irrespective of symptoms to those preferring to defer total correction until later in life, using palliative shunting if necessary.
The purpose of the present study was to analyze the result of our current surgical management by assessing the perioperative and short term follow up in the group of primary repair versus the group of two-stage repair in order to define the optimal strategy and timing of operation.
In this study we had 100 patients with TOF who had total repair of their congenital anomaly. Patients were divided into two groups, 50 patients in each group . Group A, included patients for whom underwent total repair from the beginning (50 patients), and group B, included patients for whom underwent total repair after aprevious palliative MBT shunt operation.
For both groups we have studied the pre-operative and intra-operative factors affecting the prognosis of patients with tetralogy of Fallot undergoing total repair. And full analysis of post-operative short term results and the impact of these factors on quality of life of those patients who survived the operation.
In this study , the age ranged from 24 months to 40 months with mean age ( 30 ±5)in groub A while in groub B it varies from 35 months to 72 months with mea age equals (47 ±14) , As regarding weight, It varies from (8) kg to (13) kg with mean weight (10.5 ±1.6) in groub A while in groub B it varies from (10) to (23) months with mean weight (17.3 ±4.9)
As regard the results of our study after statistical analysis of different data, the results were similar to the results of other literatures talking about this subject with very limited differences which are caused mainly by limited number of patients in this study.
We fount that there was no significant statistical difference in operative surgical approach, cardiopulmonary bypass time, or aortic cross clamping time.
A transannular patch was used in a higher incidence in the group of the primary repair in comparison to the group of two stage repair.
There was no significant statistical difference in postoperative outcomes including time to extubation, intensive care unit length of stay, and hospital length of stay.
Moreover, postoperative echocardiography revealed mild to moderate residual right ventricular outflow tract obstruction with no statistical difference between both groups.
However, it revealed presence of pulmonary regurge mostly mild to moderate with significant statistical difference being higher in group of primary repair.
There were ten hospital deaths (10%), five of them in group (A) and five in group (B).
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