Fresh Pricardium for Trans Anular Patch in Tetralogy of Fllot

Background: Total correction of tetralogy of Fallot, often require trans annular patch for RVOT reconstruction. TAP leads to free pulmonary insufficiently, and inevitable RV dysfunction, consequently. Therefore, high doses of inotropes and long time for mechanical ventilator support are required, in this regard. Several techniques have been introduced to prevent Pl and its bad consequences: Including pulmonary valve saving and leaflet augmentation for appropriate cases, homograft monocusp, contegramonocup, PTFE monocusp, and monocusptransanular patch with bovine pericardium and fresh autologous pericardium. This study aims to investigate the early results of fresh autologous pericardium for monocusp TAP. Materials & Methods: This study was performed by reviewing inpatient medical record and cardiac surgery databases of children with Tetralogy of Fallot who undergone total correction with monocusp trans-annular patch using fresh pericardium between November 2018 and September 2019. Age at the time of operation, previous history of cardiac intervention, post-operative echocardiography, length of Intensive care unit (ICU) stay, length of hospital stay, and post-operative complications (including mortality, peritoneal dialysis and phrenic nerve paresis) were recorded. Results: Among total number of 20 patients who undergone total correction with monocusp trans-annular patch using fresh pericardium 12(60%) were male. the average age of the patients was 18+6 months (8-72). TOF was diagnosed by echocardiography for all patients, two patients had atrioventricular septal defect (AVSD) as the concomitant anomaly, as well. Previous history of Blalock-Taussing (BT) shunt was positive for three patients. Post-operative course was uneventful for most of patients. Mild PI and mild pulmonary valve stenosis (PS) was detected for all patients. Mechanical ventilatory support was stopped in 6 to 12 hours post-operatively. One patient died due to severe LV dysfunction. None of the patients needed hypothermia or peritoneal dialysis. One patient had phrenic nerve paresis which required plication. The averages ICU stay and hospital stay was 36+8 (24-72) hours and 7+3 (6-10) days, respectively. Conclusion: Total correction of ToF with monocusp trans-annular patch using fresh pericardium is associated with good post-op course, short ICU stay, short hospital stay, less inotropic support and less burden on health care system and families.

کلیدواژه ها:

Tetralogy of Fallot ، Monopcusp ، Fresh pericardium ، Pulmonary insufficiency