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- Title
Primary surgical repair of tetralogy of fallot at the Uganda Heart Institute: a ten-year review of 30day mortality and morbidity.
- Authors
Khainza, Rebecca Esther; Oketcho, Michael; Aliku, Twalib; Namuyonga, Judith; Ndagire, Emma; Mwambu, Tom; Muhoozi, Rwakaryebe Mbagga; Obongnyinge, Bernard; Tumwebaze, Hilda; Mbabazi, Nestor; Akech, Teddy; Nakato, Aisha; Killen, Angelline; Ofumbi, Geoffrey Oburu; Lwabi, Peter; Omagino, John; Lubega, Sulaiman
- Abstract
Background: Tetralogy of Fallot (TOF) is the most common form of cyanotic congenital heart disease (CHD) worldwide. It accounts for 7% of CHD cases in Uganda and leads to fatal outcomes in the long term without surgery. Surgery is often delayed in developing countries like Uganda due to limited resources. Objective: This study aimed to determine the early surgical outcomes of patients with TOF who underwent primary intracardiac repair at the Uganda Heart Institute (UHI) and to identify factors associated. Methodology: This retrospective chart review evaluated outcomes of primary TOF repair patients at UHI from February 2012 to October 2022. Patient outcomes were assessed from surgery until 30 days post-operation. Results: Out of the 104 patients who underwent primary TOF repair at UHI, records of 88 patients (84.6%) were available for review. Males accounted for 48.9% (n = 43). The median age at the time of operation was 4 years (with an interquartile range of 2.5-8.0 years), ranging from 9 months to 16 years. Genetic syndromes were present in 5/88 (5.7%). These included 2 patients with trisomy 21, 2 with Noonan's, and 1 with 22q11.2 deletion syndrome. Early postoperative outcomes for patients included: residual ventricular septal defects in 35/88 (39.8%), right ventricular dysfunction in 33/88 (37.5%), residual pulmonary regurgitation in 27/88 (30.7%), residual right ventricular outflow tract obstruction in 27/88 (30.0%), pleural effusion in 24/88 (27.3%), arrhythmias in 24/88(27.3%), post-operative infections in 23/88(26.1%) and left ventricular systolic dysfunction in 9/88 (10.2%). Out of the children who underwent surgery after one year of age, 8% (7 children) died within the first 30 days. There was a correlation between mortality and post-operative ventilation time, cardiopulmonary bypass (CPB) time, aortic cross-clamp time, preoperative oxygen saturations, RV and LV dysfunction and the operating team. Conclusion: The most frequent outcomes after surgery were residual ventricular septal defects and right ventricular failure. In our study, the 30-day mortality rate following TOF repair was 8%. Deceased patients had lower pre-operative oxygen levels, longer CPB and cross-clamp times, longer post-operative ventilation, RV/LV dysfunction, and were more likely operated by the local team.
- Subjects
UGANDA; TETRALOGY of Fallot; VENTRICULAR outflow obstruction; VENTRICULAR septal defects; CONGENITAL heart disease; CARDIOPULMONARY bypass; DIGEORGE syndrome
- Publication
BMC Cardiovascular Disorders, 2024, Vol 24, Issue 1, p1
- ISSN
1471-2261
- Publication type
Article
- DOI
10.1186/s12872-024-03991-z