KEY TECHNICAL ASPECTS AND RESULTS OF RADICAL CORRECTION OF THE TETRALOGY OF FALLOT IN CHILDREN AFTER RIGHT VENTRICULAR OUTFLOW TRACT STENTING: EMPHASIS ON THE PULMONARY ARTERY VALVE

Abstract

Highlights

• The review describes the outcomes of right ventricular outflow tract stenting in children with the tetralogy of Fallot.
• The features of stent explantation and further functioning of the pulmonary artery valve after surgery are analyzed.

Aim. To analyze the technical aspects related to the explantation of stents from right ventricular outflow tract (RVOT) and repair of the pulmonary artery valve during radical correction (RC) of tetralogy of Fallot (TOF), and the results of subsequent surgical treatment of these patients.

Methods. The study included 25 children with a cyanotic TOF who received a two-stage correction of CHD (stage 1 – RVOT stenting, stage 2 – RC of TOF).

Results. Shortly after RVOT stenting, we noted positive changes in the condition of children. The median of arterial oxygen saturation rose from 80% to 95%, the gradient on RVOT decreased from 72 to 53 mmHg. After 3 months children underwent RC of TOF. Patients received palliative care in the form of RVOT stenting with a low complication rate, only 4% of patients had a fatal outcome. During RC of TOF, there were no technical difficulties regarding explantation of the stent from RVOT. The thirty-day survival rate was 96%. During RC 16% of patients avoided transannular repair procedure.

Conclusion. The patients were provided with effective palliative care such as RVOT stenting, which was reflected by improved oxygenation after the procedure and optimal growth of the pulmonary arteria and left ventricle by the time of RC. There were no technical difficulties regarding the explantation of the stent from RVOT during RC.