[Small infundibulectomy versus ventriculotomy in tetralogy of Fallot].

BACKGROUND

the surgical correction of tetralogy of Fallot (TOF) is standardized on the way to close the septal defect, but differs in the way of expanding the right ventricular outflow tract (RVOT). The aim was to compare the early postoperative clinical course of the RVOT obstruction enlargement in classical ventriculotomy technique and the small infundibulectomy (SI).

METHODS

We analyzed the database of the pediatric heart surgery service from 2008 to 2011. Patients with non-complex TOF undergoing complete correction by classical ventriculotomy or SI were selected. Anova, χ(2) and Fisher statistical test were applied.

RESULTS

the data included 47 patients, 55 % (26) male, mean age 43 months (6-172), classical ventriculotomy was performed in 61.7 % (29). This group had higher peak levels of lactate (9.07 versus 6.8 mmol/L) p = 0049, and greater magnitude in the index bleeding/kg in the first 12 hours (39.1 versus 20.3 mL/kg) p = 0.016. Death occurred in 9 cases (31.03 %) versus one (5.6 %) in the SI group with p = 0.037; complications exclusive as acute renal failure, hemopneumothorax, pneumonia, permanent AV-block and multiple organ failure were observed.

CONCLUSIONS

morbidity and mortality was higher in classical ventriculotomy group in comparison with SI. This is possibly associated with higher blood volume.