Clinical Analysis Of Radical Correction Of Adult Tetralogy Of Fallot

Objective:To summarize the clinical experience of surgical treatment of Adult Tetralogy of Fallot.Methods:80 cases of adult Tetralogy of Fallot had underwent surgical operation from October 2008 to October 2010.There were 43 males and 37 females aging from 14 years to 50 years old, mean age(26.3±12.5)years, and weighted from 25kg to 72kg,average weight(45.4±16.7)kg. All the patients had both cyanosis, and 60 patients had the history of squat. The hemoglobin is 148-225g/L, average hemoglobin(168.5±21.2)g/L. Electrocardiogram showed right ventricular hypertrophy. Chest X-ray film showed Boot-shaped heart, and all had reduced pulmonary blood. Pulmonary blood flow reduced in all the cases. Peripheral oxygen saturation was 54.6-89.7%,with an average peripheral oxygen saturation(78.4±6.1)%. All the cases had received radical correction of Tetralogy of Fallot under hypothermic cardiopulmonary bypass.Results:In this study,4 patients died after surgery. The remaining patients mechanical ventilation time was 24.9±28.4 hour, ICU stay time was 59.8±45.1 hour, length of hospital stay was 15.1±6.3 day. The complications include 7 cases of arrhythmia,IIIdegree atrioventricular block in 1 case, installation of permanent pacemaker, the other 6 cases of atrial fibrillation; drainage of the pleural effusion required in 6 cases; prolonged mechanical ventilation, tracheotomy lung infection occurred in one case;two cases because of excessive postoperative drainage, re-thoracotomy to stop bleeding.Conclusion:1. Adult patients with Tetralogy of Fallot sex was no significant correlation with prognosis; age was correlation with prognosis,the age between 14 and 18 had higher incidence of complications.2. Adult Tetralogy of Fallot after radical surgery to increase pulmonary blood flow, organizations significantly improved oxygen supply, but no significant changes in left ventricular function.3. Patients with poor left ventricular developed serious condition, maintain the respirator after surgery and ICU care time longer, need to strengthen perioperative.4. Adult patients with Tetralogy of Fallot complicated disease, the key factors of result after surgery including sufficient discharge to the right ventricular outflow tract obstruction, reasonable widened pulmonary, well ventricular septal defect repaired.