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Total correction of tetralogy of Fallot without “routine”preoperative cardiac catheterization—management of 99 patients

Published online by Cambridge University Press:  19 August 2008

Ayse Sarioglu ,
Gülhis Batmaz ,
Mehmet Salih Bilal ,
Irfan Levent Saltik ,
Gül Saylam ,
Tayyar Sarioglu ,
Aydin Aytac  and
Ali Ertugrul
Ayse Sarioglu*
Affiliation:
From the Department of Pediatric Cardiology, Institute of Cardiology, University of Istanbul and the Department of Cardiovascular Surgery, Florence Nightingale Hospital, Istanbul
Gülhis Batmaz
Affiliation:
From the Department of Pediatric Cardiology, Institute of Cardiology, University of Istanbul and the Department of Cardiovascular Surgery, Florence Nightingale Hospital, Istanbul
Mehmet Salih Bilal
Affiliation:
From the Department of Pediatric Cardiology, Institute of Cardiology, University of Istanbul and the Department of Cardiovascular Surgery, Florence Nightingale Hospital, Istanbul
Irfan Levent Saltik
Affiliation:
From the Department of Pediatric Cardiology, Institute of Cardiology, University of Istanbul and the Department of Cardiovascular Surgery, Florence Nightingale Hospital, Istanbul
Gül Saylam
Affiliation:
From the Department of Pediatric Cardiology, Institute of Cardiology, University of Istanbul and the Department of Cardiovascular Surgery, Florence Nightingale Hospital, Istanbul
Tayyar Sarioglu
Affiliation:
From the Department of Pediatric Cardiology, Institute of Cardiology, University of Istanbul and the Department of Cardiovascular Surgery, Florence Nightingale Hospital, Istanbul
Aydin Aytac
Affiliation:
From the Department of Pediatric Cardiology, Institute of Cardiology, University of Istanbul and the Department of Cardiovascular Surgery, Florence Nightingale Hospital, Istanbul
Ali Ertugrul
Affiliation:
From the Department of Pediatric Cardiology, Institute of Cardiology, University of Istanbul and the Department of Cardiovascular Surgery, Florence Nightingale Hospital, Istanbul
*
Dr. Ayse Sarioglu, Department of Pediatric Cardiology, Institute of Cardiology, University of Istanbul, Haseki 34304, Istanbul, Turkey. Tel. 90-212-589-5707; Fax. 90-212-529-4262.
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Summary

Between January 1989 and March 1993, total correction was performed in 99 patients with tetralogy of Fallot without submitting them to prior cardiac catheterization. The age of the patients ranged from 1.33 to 18 years (mean 5.33±3.77). After complete echocardiographic examination, the diameters of the right and left pulmonary arteries at the prebranching point and the descending thoracic aorta at the diaphragm were measured by cross-sectional echocardiography and the McGoon ratio was calculated. Total correction was performed in all patients with a McGoon ratio greater than 1.7. In none of the patients were the sizes of the pulmonary artery measured by echocardiography smaller than the measurements obtained during surgery. Transannular patching was performed in 76 patients. A conduit from the right ventricle to the pulmonary arteries was constructed in two patients with coronary arterial anomalies. Postrepair right ventricular to left ventricular systolic pressure ratios were between 0.25 and 0.85 (mean 0.54±0.13). There were two hospital deaths, neither being related to the diagnostic method used nor the criteria for surgery. We conclude that the diagnosis of tetralogy of Fallot together with measurements of pulmonary arteries and descending thoracic aorta can safely and reliably be achieved echocardiographically. The McGoon ratio can be adapted to echocardiography and total correction can be performed successfully based on echocardiographic examination.

Keywords

Tetralogy of Fallotechocardiographytotal correction
Type
Original Articles
Information
Cardiology in the Young , Volume 4 , Issue 3 , July 1994 , pp. 262 - 266
Copyright
Copyright © Cambridge University Press 1994

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