Comparative study between effect of Milrinone as a positive inotropic agent and Dobutamine in separation from cardiopulmonary bypass in fallot tetralogy repaired by transannualar patch technique

Abstract

etralogy of Fallot represents 10% of all congenital heart defects and is the most common form of cyanotic heart disease. There are three major goals of the TOF repair: (i) maximal relief of right ventricular out flow obstruction; (ii) separation of the systemic and pulmonary circulation by closure of the VSD; and (iii) preservation of right ventricle function, determination of the levels of obstruction of the ventricular out flow obstruction, and continuity of the pulmonary arteries Survival beyond the fourth decade is very rare in untreated patients. Without surgery, 25-35% of children with TOF die in the first year of life, 40-50% by year 3, 70-76% by year 10, 90% by year 21, and 95% by year 40. The outcome is even worse for the subset of patients with pulmonary atresia (PA). Without surgery, most of these children don’t survive beyond infancy. Even those children who are completely palliated show delayed growth and development compared with their normal children. Benefits of early complete repair: 1. Promote normal growth and development of organs. 2. Eliminate hypoxemia. 3. Less need for extensive right ventricular muscle excision. 4. Better late left ventricular function