활로 4 징증의 외과적 치료

Surgical Treatment of Patients with Tetralogy of Fallot

Ninety-six patients with tetralogy of Fallot have undergone either primary total correction [71], staged total correction [9], or an initial shunt [16], between January, 1984, and December, 1987 Their mean age was 9.5 years, mean body weight 24kg, and mean body surface area 0.86m2. Initial palliative shunt group had smaller size, smaller pulmonary artery, and higher hemoglobin [P value < 0.05 >. Modified Blalock-Taussig shunt was performed most commonly. Patch enlargement of right ventricle in 31 cases [38%], right ventricle and pulmonary artery in 7 cases [9%], transannular patch enlargement in 28 cases [35%], and valved conduit in 2 cases [2.5%] was performed for reconstruction of right ventricular outflow tract stenosis. Longer aorta cross clamp time was noted in case of separate patch enlargement of right ventricle and pulmonary artery, and dead patient with transannular patch enlargement [P value < 0.05]. There was no operative death in shunt group, but 7 deaths in total correction group [mortality rate 8.8%].