[II-P38-04] 小児におけるファロー四徴症修復の後の再施術の危険因子
Keywords:Tetralogy of Fallot, right ventricular outflow tract, children
Purpose : Reintervention after primary repair of tetralogy of Fallot (TOF) due to residual right ventricular outflow tract obstruction (RVOTO) or peripheral pulmonary stenosis (PS) is a common unavoidable complication. Methods : We reviewed patients who are undergone the primary TOF repair under 18 years of age between March 2011 and December 2017. Patients who are diagnosed as pulmonary atresia, abscent pulmonary valve syndrome were excluded. Finally, 278 patients are enrolled in this study.Results: 24 (8.6%) of patients got repair operation before their age was 100 days. 227 (81.7%) of patients got valve sparing repair while 47 (16.4%) got transannular RVOT patch and 3 (1.1%) god PV-PA conduit surgery. Only one death occurred. 55 (19.8%) patients required reinterventions and 23(8.3%) of them were re-operated. 23 patients required repeated procedures. Children with combinded congenital heart disease (P=0.020), combined angioplasty (P=0.005), previous palliation (P=0.001), perioperative complication (P=0.025) needed reintervention more frequently. Patients who underwent primary repair before the age of 100 days were also more likely to undergo reintervention (P=0.002). Immediate postoperative RV/LV pressure (P=0.005), RVOT velocity before repair (P=0.007), postoperative RVOT velocity (P=0.038) were higher and PV z score (P=0.000), LPA size (P=0.000), McGoon ratio (0.000) were lower in reintervention group. Conclusions : Primary TOF repair showed satisfactory outcome of mortality. Close observation is required especially children with risk factors of reintervention.