Short term results of Tetrology of Fallot`s Repair without Monocusp valve reconstruction of Right Ventricular Outflow Tract

Background: Tetrology of fallots is the most common cyanotic heart disease. Timely surgical intervention can change the natural history. The current trend in the management strategy of TOF is to preserve the pulmonary valve function with the aim to avoid pulmonary regurgitation (PR). The techniques to preserve pulmonary valve function include avoidance of trans annular patch (TAP) , the use of limited TAP technique when application of patch is in evitable, with acceptance of mild gradient , (that is equal or less than 40mmHg) at the right ventricular outflow tract (RVOT), or the monocuspid valve in the RVOT . We try to preserve pulmonary valve cusps, use limited trans annular patch technique and we do not use monocusp valve to re construct the RVOT. Materials Methods: We conducted a retrospective review of a prospectively collected database of all cases of TOF repair that were done at children hospital Lahore between January 2015 to December 2015 (1 year ). Results: from January 2015 to December 2015, 50 patients had TOF repair. Average age was 63 months and average weight was 12.5Kg. Mortality was 4%. Average time on ventilator was 28 hours, and average time for inotropic support was 48 hours.average post operative RVOT gradient was 28mmHg. Average hospital stay was 5 days. 18% didn’t have PR. 48% had mild PR and 34% had moderate PR. Conclusion: Tetrology of fellot has good short term results in an expert hands. With limited trans annular patch, preserving the native pulmonary valve cusps and leaving and acceptable residual RVOT gradient can produce excellent results