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Cited by 22Congenital Heart Disease StudiesCardiac Structural Anomalies and RepairCongenital heart defects research

Late surgical treatment of tetralogy of Fallot

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Tchoumi, J.C.T., Ambassa, J.C., Giamberti, A., Cirri, S., Frigiola, A., Butera, G.·2011·CardioVascular Journal of Africa
DOI 10.5830/cvja-2010-057PMC PMC3721949
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Abstract

AIM: To study early post-operative results and follow up of patients over a year old, operated on for tetralogy of Fallot (ToF). METHODS: This retrospective analysis included 22 patients (14 male and eight female) with a mean age of 9.18 ± 6.5 years (range 13.5 months to 26 years), who underwent complete repair of ToF between April 2003 and June 2009. Data from patients' records, pre-operative cardiac catheterisation studies, operative intervention, and pre-operative and postoperative two-dimensional echocardiographic studies were reviewed. All patients underwent complete repair including closure of ventricular septal defect (VSD). A trans-annular patch was used in 12 patients while an infundibular patch was used in 10 others. Patients were evaluated one, three, six and 12 months after surgery, and annually thereafter. The duration of follow up was from eight months to six years post surgery. RESULTS: Classical ToF was found in 10 patients. Twelve cases had associated anomalies: two patients with hypoplastic pulmonary artery branches, two with arterial duct malformations, and eight had proximal stenosis of the left branch of the pulmonary artery. NHYA class distribution was as follows: class I: two patients; class II: five subjects; class III: 10 patients; class IV: five subjects. The mean stay in hospital was 15 ± 7 days. Two patients (9%) died during the early post-surgical period. At a mean follow-up interval of 32 ± 9 months, all patients were asymptomatic and in NYHA class I. No late deaths occurred. In three patients, we registered isolated monomorphic ventricular extrasystoles. The right ventricle outflow tract (RVOT) pressure gradient was 29 ± 1.5 mmHg in the acute post-surgical period and it did not change significantly during follow up. The right ventricular function was defined as normal in 95% of the patients in the study and was mildly depressed in 5%. CONCLUSION: Even if treated later in life, our study showed very good surgical results of patients with ToF.

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Crossref · 10.5830/cvja-2010-057

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  • In LMICs, delayed diagnosis due to scarcity of congenital cardiology experts, lack of infrastructures, and lack of financial resources are among the hurdles found in most countries.

    “Delayed diagnosis due to the scarcity of congenital cardiology experts, lack of infrastructures, and lack of financial resources are among the hurdles found in most of these countries.12,13”

    From Tetralogy of Fallot in Low- and Middle-Income Countries (2024) · cites this paper as [12]

    The Discussion (page not provided) says that inadequate medical facilities and patients’ poverty led to late diagnosis and surgery in the authors’ Cameroonian cases. The Abstract also identifies diagnostic facilities as a barrier in developing countries. The paper does not identify a scarcity of congenital cardiology experts or establish that these hurdles occur in most LMICs. (LLM, conf=0.87)

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  • Patients from LMICs exhibit a higher number of symptoms due to prolonged hypoxic exposure.

    “Patients from LMICs exhibited a higher number of symptoms due to prolonged hypoxic exposure.”

    From Tetralogy of Fallot in Low- and Middle-Income Countries (2024) · cites this paper as [12]

    The Discussion (page not provided) says that surgery was delayed in the Cameroonian cohort and that hypoxic spells caused stiffness and lower-limb hypotony. It does not establish that patients in LMICs generally have a higher number of symptoms than patients elsewhere, or compare symptom counts between groups. (LLM, conf=0.85)

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  • More than half of patients with tetralogy of Fallot in LMICs experience dyspnea, syncope, chest pain, and seizures.

    “Indeed, more than half of the patients experienced dyspnea, syncope, chest pain, and seizures.12,13,17, 21, 22, 23”

    From Tetralogy of Fallot in Low- and Middle-Income Countries (2024) · cites this paper as [12]

    The Discussion reports hypoxic spells and lower-limb problems before surgery, while the Results give NYHA classes for the Cameroonian cohort. Neither section reports how many patients experienced dyspnea, syncope, chest pain, or seizures. Searches for those symptoms and their prevalence found no passage supporting the claim. (LLM, conf=0.74)

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Authors
Tchoumi, J. C. T., Ambassa, J. C., Giamberti, A., Cirri, S., Frigiola, A., & Butera, G.
Affiliations
IRCCS Policlinico San Donato (IT)
ORCID
Venue
CardioVascular Journal of Africa
Publisher
Clinics Cardive Publishing
Published
2011-08-23
Volume
22
Issue
4
Pages
179-181
ISSN
  • 1015-9657 (ISSN-L)
  • 1995-1892
  • 1680-0745
DOI
10.5830/cvja-2010-057
PMC
PMC3721949
OpenAlex
W2028609113
Cited by
22
References
16
Citations by year
2026: 1 · 2025: 2 · 2024: 4 · 2023: 1 · 2021: 1 · 2020: 2 · 2019: 5 · 2017: 1 · 2016: 3 · 2014: 1 · 2013: 1
FWCI
0.48
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Cardiovascular journal of South Africa/Cardiovascular journal of Southern Africa (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Archivio Istituzionale della Ricerca - Università Vita-Salute San Raffaele (submittedVersion)
Topics
  • Health Sciences › Medicine › Epidemiology › Congenital Heart Disease Studies
  • Health Sciences › Medicine › Surgery › Cardiac Structural Anomalies and Repair
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Congenital heart defects research
Keywords
tetralogy of Fallot, late surgical repair, complete repair, ventricular septal defect closure, right ventricular function, postoperative outcomes, premature ventricular contractions, pulmonary artery stenosis
MeSH terms
Adolescent, Adult, Cameroon, Child, Child, Preschool, Developing Countries, Female, Cardiac Surgical Procedures, Humans, Infant, Male, Retrospective Studies, Tetralogy of Fallot, Time Factors, Ultrasonography, Chi-Square Distribution, Treatment Outcome, Young Adult

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