OBJECTIVE

To evaluate in-hospital results of one-stage radical correction (RC) of tetralogy of Fallot (TF) and step-by-step correction with stenting of the right ventricular outflow tract (RVOT).

MATERIAL AND METHODS

The group of step-by-step correction included 24 patients with classical cyanotic form of TF: stage 1 — RVOT stenting (n=24, median age 73.5 days, weight 3.8 kg), stage 2 — RC of TF (median age 187 days). The group of one-stage RC of TF included 30 newborns with mean age of 121.5 days and weight of 5.5 kg.

RESULTS

RVOT stenting was followed by significant increase in SpO2 from 80 to 94%, indexed LV end-diastolic volume from 24 to 33.3 ml/m², decrease in severity of pulmonary artery hypoplasia compared to stage before RVOT stenting (p<0.05). Patients of both groups had equivalent values of weight, SpO2, severity of pulmonary artery hypoplasia and RVOT pressure gradient at the time of RC. After RC, we observed increment of SpO2 to 98%, decrease in RVOT pressure gradient from 75 to 16.5 mm Hg, increase in indexed LV end-diastolic volume to 56.5 ml/m² in RVOT stenting group (p<0.05). Dynamics of clinical status was similar in both groups.

CONCLUSION

Step-by-step correction of TF with RVOT stenting in low-weight newborns with severe hypoxemia demonstrated a comparable effect regarding SpO2 and reverse remodeling of the heart compared to simultaneous RC of classical TF.