Indication and technique of total correction of tetralogy of Fallot in 228 patients.

BACKGROUND

Several factors, such as old age, high hemoglobin level, pulmonary artery hypoplasia, and diminutive left ventricle, have been identified as high risk factors for operative mortality. This group of patients includes all these factors.

METHODS

Between September 1987 and March 1995, I performed total correction of tetralogy of Fallot on 228 unselected consecutive patients at Fu Wai Hospital in Beijing. There were 140 male and 88 female patients.

RESULTS

Only 2 patients died of nonsurgical causes postoperatively. The mortality was 0.9%. The remaining patients recovered uneventfully. The late mortality was 1.8% (4/228).

CONCLUSIONS

The results suggested that hypoplastic pulmonary artery and left ventricle were not an absolute contraindication of total correction of tetralogy of Fallot. High hematocrit and old age were also not high risk factors causing death. The key factor was to correct the pathology completely and manage the complications properly.