Souaga Kouassi Antonin, Bonny Rebecca, Katche Eric Koutoua, KiriouaKamenan Aime Yoboua, Amani Anderson Kwadjau, Degré Jean Calaire, Niava Randolph Gnamien, Kouamé Joseph, Yapo Paul, Kendja Flavien Kouassi
Cardiovascular Surgery Department, the Abidjan Heart Institute, Abidjan, Ivory Coast.
Anesthesia and Intensive Care Department, the Abidjan Heart Institute, Abidjan, Ivory Coast.
Kardiochir Torakochirurgia Pol. 2022 Sep;19(3):130-134. doi: 10.5114/kitp.2022.119760. Epub 2022 Oct 8.
Right ventricular dysfunction is a cause of morbidity and mortality after surgical correction of tetralogy of Fallot. The transatrial-transpulmonary approach allows preservation of right ventricular function.
To report the immediate and long-term results of surgical treatment of tetralogy of Fallot using the transatrial-transpulmonary approach.
This is a retrospective study including cases of tetralogy of Fallot operated on by the transatrial-transpulmonary approach between April 2009 and October 2010 in our institution.
There were 19 patients including 10 girls and 9 boys with a mean age of 7.4 years (extremes: 3 and 19 years). All our patients benefited from closure of the ventricular septal defect by a right atrial approach and enlargement of the pulmonary pathway. In the immediate postoperative period, the pressure gradient between the pulmonary artery and the right ventricle was 18.77 mm Hg. We had 2 deaths (10.5%). Complications were dominated by conduction disorders (100%) such as right bundle branch block and pleuropulmonary complications (41.20%). After a mean follow-up of 11.43 ±0.81 years, no patient died and all were asymptomatic, without significant residual lesion.
Complete cure of tetralogy of Fallot by the transatrial-transpulmonary route is associated with low morbidity and mortality in our experience. The long-term results are satisfactory.
右心室功能障碍是法洛四联症手术矫正后发病和死亡的一个原因。经心房-肺动脉入路可保留右心室功能。
报告采用经心房-肺动脉入路手术治疗法洛四联症的近期和远期结果。
这是一项回顾性研究，纳入了2009年4月至2010年10月在本机构采用经心房-肺动脉入路进行手术的法洛四联症病例。
共有19例患者，其中10名女孩和9名男孩，平均年龄7.4岁（范围：3至19岁）。所有患者均通过右心房入路闭合室间隔缺损并扩大了肺动脉通道。术后即刻，肺动脉与右心室之间的压力梯度为18.77毫米汞柱。我们有2例死亡（10.5%）。并发症以传导障碍（100%）如右束支传导阻滞和胸膜肺部并发症（41.20%）为主。平均随访11.43±0.81年后，无患者死亡，所有患者均无症状，无明显残余病变。
根据我们的经验，经心房-肺动脉途径完全治愈法洛四联症的发病率和死亡率较低。远期结果令人满意。
