Complex assessment of complications in operated patients with Fallot's tetrad at the hospital stage

Rakhima Mekenbayeva 1 * , Anar Sarsembayeva 1, Akkerbez Adilbek 1, Dias Vakpayev 1, Nigina Mekenbaeva 2, Arman Akseitov 2
More Detail
1 Pediatric Cardiac Surgery Department, National Scientific Medical Center, Nur-Sultan city, Republic of Kazakhstan
2 Astana Medical University, Nur-Sultan city, Republic of Kazakhstan
* Corresponding Author
J CLIN MED KAZ, Volume 4, Issue 54, pp. 25-33. https://doi.org/10.23950/1812-2892-JCMK-00685
OPEN ACCESS 2134 Views 1748 Downloads
Download Full Text (PDF)

ABSTRACT

Fallo's tetrad - one of the most often found congenital heart disease. The relevance of a problem of complications after cardiac operations at the Fallo's tetrad remains acute for today. The analysis of results of expeditious treatment and complications will allow to solve problems of timely diagnostics, treatment and prevention of the reasons of an unsatisfactory clinical condition of patients at all stages of postoperative maintaining.
Objective: Studying the structure of postoperative complications, determination of the causes of postoperative complications at a hospital stage at patients after a definitive and palliative repair of Fallo's tetrad definition of diagnostic and medical tactics in the postoperative period.
Material and methods: The studied patients with Fallo's tetrad (126 children aged from 2 days till 9 years, from them boys - 64, girls - 62) were distributed on 2 main groups: after the definitive repair of defect (DRD) and after the palliative correction of defect (PCD). The complex assessment of postoperative complications at patients with TF was carried out with use of clinical-laboratory research methods.
Results: Complications at a hospital stage arose in 38 (45.2%) cases from 84 (100%) patients after a definitive repair and in 17 (50%) cases from 34 (100%) – after palliative correction of Fallo's tetrad. The structure of complications after a definitive and palliative repair of defect is defined. The reasons and risk factors of development of postoperative complications after surgical correction of Fallo's tetrad are defined. Features of a clinical current of complications after a definitive and palliative repair of Fallo's tetrad are noted. Optimum tactics in treatment of postoperative complications at a hospital stage after a definitive and palliative repair of Fallo's tetrad is defined.
Keywords: Fallo's tetrad, radical and palliative correction, post-operative complications

CITATION

Mekenbayeva R, Sarsembayeva A, Adilbek A, Vakpayev D, Mekenbaeva N, Akseitov A. Complex assessment of complications in operated patients with Fallot's tetrad at the hospital stage. Journal of Clinical Medicine of Kazakhstan. 2019;4(54):25-33. https://doi.org/10.23950/1812-2892-JCMK-00685

REFERENCES

  • Kirklin J.W., Barratt-Boyes B.G. Cardiac surgery: Morphology, diagnostic criteria, natural history, techniques, results, and indications. N.Y.; 2013; 4.
  • Mavroudis C. Pediatric cardiac surgery. Mosby. 2012. https://doi.org/10.1002/9781118320754
  • Omelchenko A.Yu., Soynov I.A., Gorbatykh Yu.N., kulyabin Yu.Y., Gorbatykh A.V., Nichay N.R., Voitov A.V., Bogochev-Prokofiev A.V. Palliative correction in patients with tetralogy of Fallot. Medical Almanac. 2017; 3 (48):28-32
  • Hashemzadeh K., Hashemzadeh S. Early and Late Results of Total Correction of Tetralogy of Fallot. Acta Medica Iranica. 2010; 48(2): 117-122. 
  • Yang S, Wen L, Tao S, Gu J, Han J, Yao J, Wang J. Impact of timing on in-patient outcomes of complete repair of tetralogy of Fallot in infancy: an analysis of the United States National Inpatient 2005-2011 database. BMC Cardiovasc Disord. 2019; 26;19(1):46. https://doi.org/10.1186/s12872-019-0999-1
  • Menaissy Y, Omar I, Mofreh B, Alassal M. Total Correction of Tetralogy of Fallot in the First 60 Days of Life in Symptomatic Infants: Is It The Gold Standard? Thorac Cardiovasc Surg. 2019. https://doi.org/10.1055/s-0039-1678698
  • Martins IF, Doles IC, Bravo-Valenzuela NJM, Santos AORD, Varella MSP. When is the Best Time for Corrective Surgery in Patients with Tetralogy of Fallot between 0 and 12 Months of Age? Braz J Cardiovasc Surg. 2018; 33(5):505-510. https://doi.org/10.21470/1678-9741-2018-0019
  • Zlochevskaya E.V. Diagnosis and treatment of complications arising after radical correction of tetrad of Fallot at the hospital stage. Thesis and abstract on the HAC of the Russian Federation 14.00.06, candidate of medical Sciences. Moscow. 2004.
  • Podzolkov V.P., Alekyan B.G., Kokshenev I.V., Cheban V.N. Repeated operations after correction of congenital heart defects. M.: Bakulev Russian Academy of medical Sciences; 2013.
  • Gatzoulis M.A., Balaji S., Webber S.A. et al. Risk factors for arrhythmia and sudden cardiac death late after repair of tetralogy of Fallot: a multicentre study. Lancet. 2000; 356:975–81 https://doi.org/10.1016/S0140-6736(00)02714-8
  • Küçük M, Özdemir R, Karaçelik M, Doksöz Ö, Karadeniz C, Yozgat Y, Meşe T, Sarıosmanoğlu N. Risk factors for thrombosis, overshunting and death in infants after modified blalock-taussig shunt. Acta Cardiol Sin. 2016; 32(3):337–342. https://doi.org/10.6515/acs20150731a
  • Van Straten A., Vliegen H.W., Hazekamp M.G., de Roos A. Right ventricular function late after total repair of tetralogy of Fallot. Eur. Radiol. 2005; 15:702–7. https://doi.org/10.1007/s00330-004-2574-z
  • de Castilhos GM, Ley ALG, Daudt NS, Horowitz ESK, Leiria TLL. Routine Detection of Atrial Fibrillation/Flutter Predicts a Worse Outcome in a Cohort of Tetralogy of Fallot Patients During 23 Years of Follow-Up. Pediatr Cardiol. 2019; 40(5):1009-1016. https://doi.org/10.1007/s00246-019-02106-2
  • Bacha EA, Scheule AM, Zurakowski D et al. Long-term results after early primary repair of tetralogy of Fallot. J. Thorac Cardiovasc Surg. 2001; 122:154–161 https://doi.org/10.1067/mtc.2001.115156
  • Protocol of diagnosis and treatment republican center for health development of the Ministry of health of the Republic of Kazakhstan from 2015 :"Tetralogy of Fallot in children»
  • Dawoud MA, Abd Al Jawad MN, Hikal T, Samir K. Single-Stage Complete Repair versus Multistage Repair of Tetralogy of Fallot with Borderline Pulmonary Arteries. Heart Surg Forum. 2018; 13;21(6):E466-E471. https://doi.org/10.1532/hsf.2075
  • Tamesberger MI, Lechner E, Mair R et al. Early primary repair of tetralogy of Fallot in neonates and infants less than four months of age. Ann Thorac Surg. 2008; 86:1928–1936. https://doi.org/10.1016/j.athoracsur.2008.07.019
  • Coren ME, Green C, Yates R, Bush A. Complications of modified Blalock-Taussig shunts mimicking pulmonary disease. Arch Dis Child. 1998; 79(4):361-2. https://doi.org/10.1136/adc.79.4.361
  • The Clinical Protocol of treatment and diagnostics "Diagnosis of treatment of DIC syndrome" was approved by the scientific council of NSMC at 09.09.2015.
  • The Clinical Protocol of treatment and diagnosis "Criteria for determining nosocomial infections" was approved by the scientific council of NSMC at 31.01.2012
  • The Clinical Protocol of treatment and diagnostics "Radical correction of Tetralogy Fallot" is approved by the scientific council of NSMC at 31.01.2012
  • The Clinical Protocol of treatment and diagnosis "Cardiac sepsis in children" approved by the scientific council of NSMC at 09.09.2015