Critical form of tetralogy of Fallot: right ventricular outflow tract stenting or modified Blalock-Taussig shunt?

To compare the results of right ventricular outflow tract stenting and modified Blalock-Taussig shunt in infants with tetralogy of Fallot and severe pulmonary hypoplasia.

MATERIAL AND METHODS

A prospective randomized two-center study enrolled 42 patients with tetralogy of Fallot who underwent modified Blalock-Taussig shunt (n=21) or right ventricular outflow tract stenting (n=21) as a bridge to complete repair. We assessed baseline characteristics of patients before palliative care and compared the results of both procedures.

RESULTS

Mean duration of surgery (p<0.0001), vasopressor and inotropic support (p<0.0001), mechanical ventilation (p<0.0001) and hospital-stay (p<0.0001) was significantly lower after right ventricular outflow stenting. Oxygen saturation increase averaged 30% in the same patients (from 63 to 94%) compared to 17% after modified Blalock-Taussig shunt (from 69 to 87%) (p<0.00001).

CONCLUSION

Right ventricular outflow tract stenting in infants with tetralogy of Fallot is a safe procedure providing stabilization of hemodynamics, fact and significant increase in oxygen saturation with shorter period of rehabilitation.

Keywords:

staged treatment of tetralogy of Fallot

right ventricular outflow tract stenting

modified Blalock-Taussig shunt

Authors:

Morsina M.G.

Meshalkin National Medical Research Center

ORCID: 0000-0003-3870-169X

Pursanov M.G.

Meshalkin National Medical Research Center

ORCID: 0000-0002-1421-1795

Soynov I.A.

Meshalkin National Medical Research Center

ORCID: 0000-0003-3691-2848

Voitov A.V.

Meshalkin National Medical Research Center

ORCID: 0000-0003-3797-4899

Kulyabin Yu.Yu.

National Medical Research Center

ORCID: 0000-0002-2361-5847

Gorbatykh Yu.N.

Meshalkin National Medical Research Center

ORCID: 0000-0002-6204-5381

Bogachev-Prokofiev A.V.

Meshalkin National Medical Research Center

SPIN RSCI: 4448-6999
Scopus AuthorID: 55846629000
ResearcherID: L-7881-2014
ORCID: 0000-0003-4625-4631

Received:

25.07.2023

Accepted:

10.08.2023

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