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KMID : 0364019940270030202
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Korean Journal of Thoracic and Cardiovascular Surgery
1994 Volume.27 No. 3 p.202 ~ p.208
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Comparison of Tranatrial-transpulmonary and Transventricular Repair of Tetralogy of Fallot
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Abstract
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We reviewed 30 patients with tetralogy of Fallot who had underwent transannular patch reconstruction of the right ventricular outflow tract from January 1990 to May 1993. The patients were divided into two groups according to the approaching
pattern for
the corrective surgery : 12 patients(aged 11 months to 4 years; mean age, 2.3 years) in transatrial group who were repaired by transatrial-transpulmonary approach; 18 patients(aged 13 months to 6 years; mean age, 3.2 years) in transventricular
group who
were repaired by transventricular approach. The incidence of postoperative right bundle branch block was not statistically different between two groups. With follow up from 3 months to 32 months after operation, none in transatrial group revealed
a
remnant RVOT stenosis over 50mmHg or tricuspid regurgitation more than grade II with 2Dechocardiography, but two cases(7.7%) in transventricular group revealed these complications. Early postoperative death was 4 cases(13.3%) which all belonged
to
transventricular group. In conclusion successful repair of tetralogy of Fallot can be accomplished in most patients by transatrial-transpulmonary approach and we can anticipate better results by this approach in terms of postoperative right
ventricular
function and arrhythmia than conventional transventricular approach. (Korean J Thoracic Cardiovas Surg 1994; 27:202-8)
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