Early outcome of tetralogy of Fallot repair in the current era of management

Traditional use of trans-annular patch (tap) to release right ventricular outflow tract (rvot) obstruction during tetralogy of fallot (tof) repair may lead to a harmful pulmonary regurgitation. different approaches have been used to release rvot obstruction and spare the pulmonary valve (pv) function. in this study, we aim to evaluate the post-operative course of patients who had tof repair in the current era that emphasizes on protective strategy of releasing rvot obstruction and preserving pv function. methods: a retrospective study of all tof cases repaired in our institute between march 2002 and december 2007 was conducted. cases were classified into two groups; group i included patients that had a tap, while group ii included cases that had simple tof repair without tap. group i was subdivided into two groups, group (a) which include patients who had tap without a valve. group (b) includes those who had tap with a monocuspid valve (contegra). we compared postoperative care and outcome of all groups. results: eighty-three patients fulfilled the study criteria. there were 64 cases (77%) in group i, and 19 cases (23%) in group ii. all children tolerated surgical repair and did well. we observed no statistically significant difference in the post-operative icu care, complications rates and morbiditybetween all groups. there was no surgical mortality in all groups.conclusion: children undergoing tof repair had excellent short-term outcome with the currentprotective strategy aiming to spare valvular function, and conserving myocardial function. applyinga monocuspid patch technique did not show clear short-term benefits. long term follow up isneeded to evaluate future difference in different techniques.