Tetralogy of Fallot: Anatomy, Physiology, and Outcomes  

作　　者：Edo Bedzra Eli Contorno Herra Javed Amna Qasim James St.Louis Taufiek Konrad Rajab 

机构地区：[1]Department of Cardiovascular andThoracic Surgery,Children’s Mercy,Kansas City,MO,64108,USA [2]Department of Pediatric Cardiovascular Surgery,Arkansas Children’s Hospital,Little Rock,AR,72202,USA [3]Department of Pediatric Cardiology,Arkansas Children’s Hospital,Little Rock,AR,72202,USA [4]Department of Pediatric Cardiothoracic Surgery,Medical College of Georgia,Augusta,GA,30912,USA

出　　处：《Congenital Heart Disease》2024年第6期541-562,共22页先天性心脏病(英文)

基　　金：Taufiek Konrad Rajab’s research is supported by the National Institutes of Health/National Heart,Lung,and Blood Institute grant R41 HL169059;the American Association for Thoracic Surgery,the Brett Boyer Foundation,the Saving tiny Heart Society;the Emerson Rose Heart Foundation,philanthropy from Senator Campbell and the Arkansas Children’s Research Institute;supported with funding by Children’s Mercy Kansas City Ward Family Heart Center.

摘　　要：Since the first identification of Tetralogy of Fallot in 1671,consisting of a combination of anatomical defects including biventricular origin of the aorta,maligned ventricular septal defect,overriding aorta,and narrowing or atresia of the pulmonary outflow tract.The first successful operation consisted of a shunt between the left subclavian artery and pulmonary artery.Following this palliative procedure,complete repair is performed once the patient reaches indicative criteria.Since the first attempts at surgical palliation and repair,techniques and outcomes have improved drastically.Definitive repair of Tetralogy of Fallot consists of amulti-patch closure of anyVentricular SeptalDefect along with clearance of any muscular obstructions of the Right Ventricular Outflow Tract and reconstruction of the outflow tract.Current results of Tetralogy of Fallot palliation yield excellent long and short-term results with 5-year freedom from reintervention of 90%.The iterative improvement of repair techniques has greatly reduced intraoperative and postoperative complications.Future innovations such as increased use of percutaneous repair methods and additional data on the benefits of primary repair as opposed to staged palliation will continue to improve patient outcomes.

关 键 词：Tetralogy of Fallot atrioventricular septal defect SURGERY medical management REPAIR 

分 类 号：R65[医药卫生—外科学]