Comparison of Short-term Outcomes of Radical Correction of Tetralogy of Fallot with or without Transcatheter Embolization of Major Aortopulmonary Collaterals_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

 LIUChao , GUOPeng-ju , WENBing , XUHua-shan , ZHAOWen-zeng

Department of Cardiovascular Surgery, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, P. R. China;

Corresponding?author：

LIUChao, Email: liubeilun@sohu.com

Keywords：

Tetralogy of Fallot; Aortopulmonary collateral; Radical correction; Embolization; Therapeutic effect

DOI：

10.7507/1007-4848.20140179

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To compare short-term outcomes of radical correction of tetralogy of Fallot (TOF)with or without transcatheter embolization of major aortopulmonary collaterals (APC). Methods Clinical data of 58 TOF patients undergoing radical correction from January 2008 to June 2013 in the Department of Cardiovascular Surgery, First Affiliated Hospital of Zhengzhou University were retrospectively analyzed. There were 36 male and 22 female patients. Among them, 22 patients (Group A, 12 males and 10 females)received radical TOF correction combined with transcatheter embolization of major APC, and 36 patients (Group B, 24 males and 12 females)received radical TOF correction alone. Average age of group A was (24.91±6.77)years and that of group B was (22.42±5.06)years. Aortic cross-clamping time, ICU stay, postoperative hospital stay, left ventricular ejection fraction (LVEF)7 days and 3 months after the operation were compared between the 2 groups. Results There was no in-hospital death. There was no statistical difference in sex, age, preoperative McGoon ratio or hemoglobin (Hb)levels between the 2 groups (P > 0.05). Aortic cross-clamping time[ (43.87±13.02)minutes vs. (53.60±11.69)minutes, P < 0.05], ICU stay[ (26.09±4.84)hours vs. (28.87±4.38)hours, P < 0.05] and postoperative hospital stay[ (12.32±1.81)days vs. (13.67±2.14)days, P < 0.05] of group A were significantly shorter than those of group B. LVEF 7 days after the operation of group A was significantly higher than that of group B (56.64%±8.19% vs. 52.58%±5.62%, P < 0.05), and there was no statistical difference in LVEF 3 months after the operation between the 2 groups (58.50%±8.78% vs. 55.42%±6.18%, P > 0.05). Conclusion For surgical treatment of TOF, compared with radical correction alone, radical correction combined with transcatheter embolization of major APC can significantly shorten aortic cross-clamping time and improve postoperative heart function recovery.

Citation： LIUChao, GUOPeng-ju, WENBing, XUHua-shan, ZHAOWen-zeng. Comparison of Short-term Outcomes of Radical Correction of Tetralogy of Fallot with or without Transcatheter Embolization of Major Aortopulmonary Collaterals. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2014, 21(5): 632-635. doi: 10.7507/1007-4848.20140179 Copy

1.	Apitz C, Webb GD, Redington AN. Tetralogy of Fallot. Lancet, 2009, 374(9699):1462-1471.
2.	Arenz C, Laumeier A, Lütter S, et al. Is there any need for a shunt in the treatment of tetralogy of Fallot with one source of pulmonary blood flow? Eur J Cardiothorac Surg, 2013, 44(4):648-654.
3.	劉迎龍, 沈向東, 李守軍等.介入及手術聯合矯治伴有體肺動脈側枝的肺血減少型先天性心臟病.中華醫學雜志, 2006, 86(4):228-231.
4.	Ong K, Boone R, Gao M, et al. Right ventricle to pulmonary artery conduit reoperations in patients with tetralogy of fallot or pulmonary atresia associated with ventricular septal defect. Am J Cardiol, 2013, 111(11):1638-1643.
5.	胡盛壽, 李守軍, 張浩等.介入技術和外科手術同期"復合"治療先天性心臟病的臨床研究.中華心血管病雜志, 2006, 34(3):236-239.
6.	鄭哲, 李守軍, 胡盛壽等.分期和"一站式"Hybrid手術治療法洛四聯癥合并體肺動脈側枝血管形成的療效比較.中國胸心血管外科臨床雜志, 2009, 16(4):250-253.
7.	劉浪, 陳凱明, 賴鋒華, 等.雜交技術在法洛四聯癥治療中的應用.中國胸心血管外科臨床雜志, 2013, 20(1):108-110.
8.	Kon ZN, Brown EN, Tran R, et al. Simultaneous hybrid coronary revascularization reduces postoperative morbidity compared with results from conventional off-pump coronary artery bypass. J Thorac Cardiovasc Surg, 2008, 135(02):367-375.
9.	Yoo BW, Kim JO, Kim YJ, et al. Impact of pressure load caused by right ventricular outflow tract obstruction on right ventricular volume overload in patients with repaired tetralogy of Fallot. J Thorac Cardio-vasc Surg, 2012, 143(6):1299-1304.
10.	Schwartz MC, Rome JJ, Gillespie MJ, et al. Relation of left ventri-cular end diastolic pressure to right ventricular end diastolic volume after operative treatment of tetralogy of fallot. Am J Cardiol, 2012, 109(3):417-422.
11.	Maskatia SA, Spinner JA, Morris SA, et al. Effect of branch pulmonary artery stenosis on right ventricular volume overload in patients with tetralogy of fallot after initial surgical repair. Am J Cardiol, 2013, 111(9):1355-1360.
12.	Grosse-Wortmann L, Yoo SJ, van Arsdell G, et al. Preoperative total pulmonary blood flow predicts right ventricular pressure in patients early after complete repair of tetralogy of Fallot and pulmonary atresia with major aortopulmonary collateral arteries. J Thorac Cardiovasc Surg, 2013, 146(5):1185-1190.
13.	Broberg CS, Aboulhosn J, Mongeon FP, et al. Prevalence of left ventricular systolic dysfunction in adults with repaired tetralogy of fallot. Am J Cardiol, 2011, 107(8):1215-1220.
14.	Uebing A, Gibson DG, Babu-Narayan SV, et al. Right ventricular mechanics and QRS duration in patients with repaired tetralogy of Fallot:implications of infundibular disease. Circulation, 2007, 116(14):1532-1539.
15.	Diller GP, Kempny A, Liodakis E, et al. Left ventricular longitudinal function predicts life-threatening ventricular arrhythmia and death in adults with repaired tetralogy of fallot. Circulation, 2012, 125(20):2440-2446.
16.	Kempny A, Diller GP, Orwat S, et al. Right ventricular-left ventricular interaction in adults with Tetralogy of Fallot:a combined cardiac magnetic resonance and echocardiographic speckle tracking study. Int J Cardiol, 2012, 154(3):259-264.
17.	Fernandes FP, Manlhiot C, Roche SL, et al. Impaired left ventricular myocardial mechanics and their relation to pulmonary regurgitation, right ventricular enlargement and exercise capacity in asymptomatic children after repair of tetralogy of Fallot. J Am Soc Echocardiogr, 2012, 25(5):494-503.
18.	Gatzoulis MA, Balaji S, Webber SA, et al. Risk factors for arrhythmia and sudden cardiac death late after repair of tetralogy of Fallot:a multicentre study. Lancet, 2000, 356(9234):975-981.
19.	Khairy P, Harris L, Landzberg MJ, et al. Implantable cardioverter-defibrillators in Tetralogy of Fallot. Circulation, 2008, 117(3):363-370.
20.	Asija R, Hanley FL, Roth SJ. Postoperative respiratory failure in children with tetralogy of fallot, pulmonary atresia, and major aorto-pulmonary collaterals:a pilot study. Pediatr Crit Care Med, 2013, 14(4):384-389.
21.	范祥明, 劉迎龍, 閆軍, 等.肺動脈發育不良型法洛四聯癥根治術前姑息手術和介入技術的應用.中華胸心血管外科雜志, 2011, 27(10):581-583.

1. Apitz C, Webb GD, Redington AN. Tetralogy of Fallot. Lancet, 2009, 374(9699):1462-1471.
2. Arenz C, Laumeier A, Lütter S, et al. Is there any need for a shunt in the treatment of tetralogy of Fallot with one source of pulmonary blood flow? Eur J Cardiothorac Surg, 2013, 44(4):648-654.
3. 劉迎龍, 沈向東, 李守軍等.介入及手術聯合矯治伴有體肺動脈側枝的肺血減少型先天性心臟病.中華醫學雜志, 2006, 86(4):228-231.
4. Ong K, Boone R, Gao M, et al. Right ventricle to pulmonary artery conduit reoperations in patients with tetralogy of fallot or pulmonary atresia associated with ventricular septal defect. Am J Cardiol, 2013, 111(11):1638-1643.
5. 胡盛壽, 李守軍, 張浩等.介入技術和外科手術同期"復合"治療先天性心臟病的臨床研究.中華心血管病雜志, 2006, 34(3):236-239.
6. 鄭哲, 李守軍, 胡盛壽等.分期和"一站式"Hybrid手術治療法洛四聯癥合并體肺動脈側枝血管形成的療效比較.中國胸心血管外科臨床雜志, 2009, 16(4):250-253.
7. 劉浪, 陳凱明, 賴鋒華, 等.雜交技術在法洛四聯癥治療中的應用.中國胸心血管外科臨床雜志, 2013, 20(1):108-110.
8. Kon ZN, Brown EN, Tran R, et al. Simultaneous hybrid coronary revascularization reduces postoperative morbidity compared with results from conventional off-pump coronary artery bypass. J Thorac Cardiovasc Surg, 2008, 135(02):367-375.
9. Yoo BW, Kim JO, Kim YJ, et al. Impact of pressure load caused by right ventricular outflow tract obstruction on right ventricular volume overload in patients with repaired tetralogy of Fallot. J Thorac Cardio-vasc Surg, 2012, 143(6):1299-1304.
10. Schwartz MC, Rome JJ, Gillespie MJ, et al. Relation of left ventri-cular end diastolic pressure to right ventricular end diastolic volume after operative treatment of tetralogy of fallot. Am J Cardiol, 2012, 109(3):417-422.
11. Maskatia SA, Spinner JA, Morris SA, et al. Effect of branch pulmonary artery stenosis on right ventricular volume overload in patients with tetralogy of fallot after initial surgical repair. Am J Cardiol, 2013, 111(9):1355-1360.
12. Grosse-Wortmann L, Yoo SJ, van Arsdell G, et al. Preoperative total pulmonary blood flow predicts right ventricular pressure in patients early after complete repair of tetralogy of Fallot and pulmonary atresia with major aortopulmonary collateral arteries. J Thorac Cardiovasc Surg, 2013, 146(5):1185-1190.
13. Broberg CS, Aboulhosn J, Mongeon FP, et al. Prevalence of left ventricular systolic dysfunction in adults with repaired tetralogy of fallot. Am J Cardiol, 2011, 107(8):1215-1220.
14. Uebing A, Gibson DG, Babu-Narayan SV, et al. Right ventricular mechanics and QRS duration in patients with repaired tetralogy of Fallot:implications of infundibular disease. Circulation, 2007, 116(14):1532-1539.
15. Diller GP, Kempny A, Liodakis E, et al. Left ventricular longitudinal function predicts life-threatening ventricular arrhythmia and death in adults with repaired tetralogy of fallot. Circulation, 2012, 125(20):2440-2446.
16. Kempny A, Diller GP, Orwat S, et al. Right ventricular-left ventricular interaction in adults with Tetralogy of Fallot:a combined cardiac magnetic resonance and echocardiographic speckle tracking study. Int J Cardiol, 2012, 154(3):259-264.
17. Fernandes FP, Manlhiot C, Roche SL, et al. Impaired left ventricular myocardial mechanics and their relation to pulmonary regurgitation, right ventricular enlargement and exercise capacity in asymptomatic children after repair of tetralogy of Fallot. J Am Soc Echocardiogr, 2012, 25(5):494-503.
18. Gatzoulis MA, Balaji S, Webber SA, et al. Risk factors for arrhythmia and sudden cardiac death late after repair of tetralogy of Fallot:a multicentre study. Lancet, 2000, 356(9234):975-981.
19. Khairy P, Harris L, Landzberg MJ, et al. Implantable cardioverter-defibrillators in Tetralogy of Fallot. Circulation, 2008, 117(3):363-370.
20. Asija R, Hanley FL, Roth SJ. Postoperative respiratory failure in children with tetralogy of fallot, pulmonary atresia, and major aorto-pulmonary collaterals:a pilot study. Pediatr Crit Care Med, 2013, 14(4):384-389.
21. 范祥明, 劉迎龍, 閆軍, 等.肺動脈發育不良型法洛四聯癥根治術前姑息手術和介入技術的應用.中華胸心血管外科雜志, 2011, 27(10):581-583.

Previous Article
Clinical Analysis of Serous Cystadenoma of Pancreas (Report of 19 Cases)
Next Article
Diagnosis and Treatment of Pancreatic Vasoactive Intestinal Peptide Tumor (Report of 3 Cases)

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Comparison of Short-term Outcomes of Radical Correction of Tetralogy of Fallot with or without Transcatheter Embolization of Major Aortopulmonary Collaterals

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content