Surgical treatment of tetralogy of Fallot with pulmonary atresia

O. Alfieri, E. H. Blackstone, J. W. Kirklin, A. D. Pacifico, L. M. Bargeron

Research output: Contribution to journalArticle

53 Citations (Scopus)

Abstract

Thirteen (16 percent) of 80 patients with tetralogy of Fallot and pulmonary atresia undergoing corrective operations between Jan. 1, 1967, and Jan. 1, 1978, died in the hospital. The hospital mortality rate was 13 percent (10 deaths) among the 77 patients with confluent right and left pulmonary arteries. The risk of operation was not significantly affected by age at operation or by use of a valved external conduit versus a transannular outflow patch. It was affected (p=0.008) by the ratio of peak right ventricular to left ventricular pressure (PRV/LV) immediately after repair. This (PRV/LV) was determined primarily by size of left and right pulmonary arteries. An equation was developed relating postrepair PRV/LV to diameter of right and left pulmonary artery (normalized by dividing by size of descending thoracic aorta), body surface area, and possible arborization abnormalities and stenoses of the right and left pulmonary arteries. Cardiac performance after repair was better in those in whom a transannular patch was used rather than a valved external conduit. Important pulmonary dysfunction postoperatively occurred more often in patients with large 'bronchial' arteries than in those without them, but was less when these were not ligated. Four (8 percent) of 48 traced hospital survivors died late postoperatively. Reoperations late postoperatively were required only in patients receiving valved external conduits. Forty (91 percent) of 44 living traced patients are asymptomatic.

Original languageEnglish
Pages (from-to)321-335
Number of pages15
JournalJournal of Thoracic and Cardiovascular Surgery
Volume76
Issue number3
Publication statusPublished - 1978

Fingerprint

Pulmonary Atresia
Tetralogy of Fallot
Pulmonary Artery
Ventricular Pressure
Thoracic Aorta
Bronchial Arteries
Therapeutics
Body Surface Area
Hospital Mortality
Reoperation
Survivors
Pathologic Constriction
Lung
Mortality

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Alfieri, O., Blackstone, E. H., Kirklin, J. W., Pacifico, A. D., & Bargeron, L. M. (1978). Surgical treatment of tetralogy of Fallot with pulmonary atresia. Journal of Thoracic and Cardiovascular Surgery, 76(3), 321-335.

Surgical treatment of tetralogy of Fallot with pulmonary atresia. / Alfieri, O.; Blackstone, E. H.; Kirklin, J. W.; Pacifico, A. D.; Bargeron, L. M.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 76, No. 3, 1978, p. 321-335.

Research output: Contribution to journalArticle

Alfieri, O, Blackstone, EH, Kirklin, JW, Pacifico, AD & Bargeron, LM 1978, 'Surgical treatment of tetralogy of Fallot with pulmonary atresia', Journal of Thoracic and Cardiovascular Surgery, vol. 76, no. 3, pp. 321-335.
Alfieri, O. ; Blackstone, E. H. ; Kirklin, J. W. ; Pacifico, A. D. ; Bargeron, L. M. / Surgical treatment of tetralogy of Fallot with pulmonary atresia. In: Journal of Thoracic and Cardiovascular Surgery. 1978 ; Vol. 76, No. 3. pp. 321-335.
@article{e9a5ec8777ed4b72b1fda690df82596e,
title = "Surgical treatment of tetralogy of Fallot with pulmonary atresia",
abstract = "Thirteen (16 percent) of 80 patients with tetralogy of Fallot and pulmonary atresia undergoing corrective operations between Jan. 1, 1967, and Jan. 1, 1978, died in the hospital. The hospital mortality rate was 13 percent (10 deaths) among the 77 patients with confluent right and left pulmonary arteries. The risk of operation was not significantly affected by age at operation or by use of a valved external conduit versus a transannular outflow patch. It was affected (p=0.008) by the ratio of peak right ventricular to left ventricular pressure (PRV/LV) immediately after repair. This (PRV/LV) was determined primarily by size of left and right pulmonary arteries. An equation was developed relating postrepair PRV/LV to diameter of right and left pulmonary artery (normalized by dividing by size of descending thoracic aorta), body surface area, and possible arborization abnormalities and stenoses of the right and left pulmonary arteries. Cardiac performance after repair was better in those in whom a transannular patch was used rather than a valved external conduit. Important pulmonary dysfunction postoperatively occurred more often in patients with large 'bronchial' arteries than in those without them, but was less when these were not ligated. Four (8 percent) of 48 traced hospital survivors died late postoperatively. Reoperations late postoperatively were required only in patients receiving valved external conduits. Forty (91 percent) of 44 living traced patients are asymptomatic.",
author = "O. Alfieri and Blackstone, {E. H.} and Kirklin, {J. W.} and Pacifico, {A. D.} and Bargeron, {L. M.}",
year = "1978",
language = "English",
volume = "76",
pages = "321--335",
journal = "Journal of Thoracic and Cardiovascular Surgery",
issn = "0022-5223",
publisher = "Mosby Inc.",
number = "3",

}

TY - JOUR

T1 - Surgical treatment of tetralogy of Fallot with pulmonary atresia

AU - Alfieri, O.

AU - Blackstone, E. H.

AU - Kirklin, J. W.

AU - Pacifico, A. D.

AU - Bargeron, L. M.

PY - 1978

Y1 - 1978

N2 - Thirteen (16 percent) of 80 patients with tetralogy of Fallot and pulmonary atresia undergoing corrective operations between Jan. 1, 1967, and Jan. 1, 1978, died in the hospital. The hospital mortality rate was 13 percent (10 deaths) among the 77 patients with confluent right and left pulmonary arteries. The risk of operation was not significantly affected by age at operation or by use of a valved external conduit versus a transannular outflow patch. It was affected (p=0.008) by the ratio of peak right ventricular to left ventricular pressure (PRV/LV) immediately after repair. This (PRV/LV) was determined primarily by size of left and right pulmonary arteries. An equation was developed relating postrepair PRV/LV to diameter of right and left pulmonary artery (normalized by dividing by size of descending thoracic aorta), body surface area, and possible arborization abnormalities and stenoses of the right and left pulmonary arteries. Cardiac performance after repair was better in those in whom a transannular patch was used rather than a valved external conduit. Important pulmonary dysfunction postoperatively occurred more often in patients with large 'bronchial' arteries than in those without them, but was less when these were not ligated. Four (8 percent) of 48 traced hospital survivors died late postoperatively. Reoperations late postoperatively were required only in patients receiving valved external conduits. Forty (91 percent) of 44 living traced patients are asymptomatic.

AB - Thirteen (16 percent) of 80 patients with tetralogy of Fallot and pulmonary atresia undergoing corrective operations between Jan. 1, 1967, and Jan. 1, 1978, died in the hospital. The hospital mortality rate was 13 percent (10 deaths) among the 77 patients with confluent right and left pulmonary arteries. The risk of operation was not significantly affected by age at operation or by use of a valved external conduit versus a transannular outflow patch. It was affected (p=0.008) by the ratio of peak right ventricular to left ventricular pressure (PRV/LV) immediately after repair. This (PRV/LV) was determined primarily by size of left and right pulmonary arteries. An equation was developed relating postrepair PRV/LV to diameter of right and left pulmonary artery (normalized by dividing by size of descending thoracic aorta), body surface area, and possible arborization abnormalities and stenoses of the right and left pulmonary arteries. Cardiac performance after repair was better in those in whom a transannular patch was used rather than a valved external conduit. Important pulmonary dysfunction postoperatively occurred more often in patients with large 'bronchial' arteries than in those without them, but was less when these were not ligated. Four (8 percent) of 48 traced hospital survivors died late postoperatively. Reoperations late postoperatively were required only in patients receiving valved external conduits. Forty (91 percent) of 44 living traced patients are asymptomatic.

UR - http://www.scopus.com/inward/record.url?scp=0018119317&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0018119317&partnerID=8YFLogxK

M3 - Article

C2 - 682664

AN - SCOPUS:0018119317

VL - 76

SP - 321

EP - 335

JO - Journal of Thoracic and Cardiovascular Surgery

JF - Journal of Thoracic and Cardiovascular Surgery

SN - 0022-5223

IS - 3

ER -