Single-Stage Complete Repair Versus Multi-Stage Repair In Tetralogy Of Fallot With Borderline Pulmonary Arteries

Abstract

etralogy of Fallot is the commonest cyanotic heart disease with prevalence from 0.21 to 0.36 per 1000 live births, and reaching about 7 to 10 % of all forms of congenital heart diseases (Ferencz et al., 1985 and Mitchell et al., 1971). Surgical management of TOF is still a debatable subject, especially whether to perform single stage complete repair or to perform systemic to pulmonary shunt surgery and delaying the complete repair. When and to which patients each surgical strategy should be applied are very complicated subjects (Stewart et al., 2013). Pulmonary arterial size is important prognostic factor in TOF management as there is a risk of right ventricular failure, if the outflow resistance remains too high after separation of pulmonary and systemic circulations (Laas et al., 1984 and Harlan et al., 1995). This study aims at evaluating the fate of 60 patients having TOF with borderline pulmonary arteries (McGoon ratio of 1.3 to 1.7) as regard to the need for a single-stage or multi-stage repair and the outcome of each surgical management. 60 patients with TOF were included in this study. The patients were divided randomizely into 2 groups: