González-Ramos LA, Ruiz-Bustamante NP, López-Cervantes G, Rascón-Alcantar A, Castillo-Aldaco J

Language: Spanish
References: 13
Page: 8-14
PDF size: 204.91 Kb.

ABSTRACT

Introduction: Fallot tetrallogy is a congenital heart disease wich is characterized by pulmonary stenosis, ventricular septal defect, aortic dextroposition and right ventricular hypertrophy. In our hospital the death cases for cardiac malformation the Fallot tetrallogy occupied the tenth place in all autopsy cases. The purpose of this paper is to present our medical and surgical experience of this malformation.
Material and Methods: We reviewed the clinical records of the Fallot tetrallogy cases that were surgical treated, and variables where chest x ray findings, EKG, echocardiogram and cardiac catheterization, the type of surgery performed and other variables presented before, during or after surgery also were reviewed.
Results: Our medical and surgical experience was limited to 24 cases. Early diagnosis was made possible due to the cyanosis, murmur, respiratory pattern and a dismorfic syndrome. Echocardiogram was the key to diagnosis for overriding of the aorta, right ventricular outlet obstructive gradient and status of pulmonary arteries and its branches. Chest x ray cardiothoracic index was less than 0.60 in 57% of all cases. In 68% of our cases EKG electrical axis with a shift to the right no more of 150° was detected. We found an atrial septal defect in one of cardiac catheterization study. Four (24%) cases who underwent corrective surgery have had residual lesions and the global surgical mortality was of 37% (9 cases).
Discussion: Although it is possible to make an early diagnosis for Fallot tetrallogy, the surgical treatment was occasionally delayed mostly due to lack of economic resources of the support program groups and the restricted medical equipment that allows to make a complete evaluation in more specific cases that require it.
Conclusion: It is possible to make an early diagnostic for Fallot tetrallogy and to do corrective surgery in cases were the anatomy permits to do so and in the future have a better outcome.

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