Central Palliation for the Tetralogy of Fallot
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概要
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Fourteen cases of TOF were performed on the RVOT construction without closure of the VSD which was called central palliation. The cases consisted of an equal number of males and females. These patients ranged in age from six to forty-five years. Before central palliation, initial palliative shunt was carried out in five cases. The remaining nine cases were provided with the central palliation as the initial surgery. Twelve cases showed the ratio of PA/AO below one fourth or the ratio of RPA/AO below 0.3. Two cases showed an abnormal right coronary traversing the right ventricle. Resection of the abnormal right ventricle muscle band and pulmonary valvuloplasty were performed in nine cases (group A) and the placement of a patch graft was done in five cases (group B). Arterial oxygen saturation was increased in both groups postoperatively. The postoperative hematocrit was decreased in both groups. Postoperative PA/AO ratio became 1/3 in group A and 1/2.3 in group B, respectively. Symptomatic improvement was good, especially in group B. The preoperative state of group B patients was classified as NYHA functional class IV. After central palliation, four cases changed to NYHA functional class II and one case could not be located during the follow up period. Determination of the proper time for central palliation correction remains a problem that must be solved in the future. The time necessary for total correction will be about three or four years with occasional observation and follow up.
- 1985-12-02
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