Clinical outcomes of tetralogy canal repair: A multidisciplinary perspective

Abstract

Objectives: To assess the surgical outcomes of atrioventricular septal defect associated with Tetralogy of Fallot (AVSD)-TOF repair performed at 2 specialized cardiac centers.

Methods: From May 2012 to December 2024, 20 patients diagnosed with AVSD-TOF who underwent surgical repair were included.

Results: The median age at the time of surgical repair was 13 months, with a median weight of 8.2 kg (IQR: 6.2-11.5 kg). Biventricular repair was successfully performed in 18 patients (90%), while one and half ventricular repair was required in 2 patients (10%). Before definitive repair, palliative procedures, including bidirectional Glenn shunts, were carried out in 2 patients (10%), and right ventricular outflow tract (RVOT) stenting in another 2 patients (10%). Postoperative complications included a third-degree heart block requiring pacemaker implantation in 10% and chylothorax in 15%. The median duration of chest drains was 10 days. In 40% of patients, reintervention was required, involving catheter-based procedures and redo surgeries for residual lesions. Despite these complexities, overall survival was 90%, with all patients surviving to hospital discharge.

Conclusion: Biventricular repair of AVSD-TOF is feasible and offers favorable early survival. However, the complexity of the condition, frequent reinterventions, and residual lesions highlight the need for individualized surgical/interventional planning and long-term follow-up.

Keywords: Atrioventricular septal defect; Multidisciplinary Care; Outcome; Pediatrics; Tetralogy of Fallot.

Figure 1

- Shows the Kaplan-Meier survival analysis of the studied patients.