Minimally Invasive Cardiac Surgery for Treating Tetralogy of Fallot in Children in the Modern Era.

Abstract

This study gives evaluations of the early-term results of minimally invasive cardiac surgery for definitive treatment of tetralogy of Fallot (TOF). A study of 46 patients who were aged ≥3 months and suffered TOF was carried out during a period from May 2023 to May 2024. All 46 patients (mean age, 8.4 months; weight, 7.1 ± 1.8 kg) underwent TOF repair through right vertical infra-axillary thoracotomy. Only 1 patient required reintervention for electrode wire bleeding, managed through the same incision. Mean cardiopulmonary bypass and aortic clamp times were 174 ± 48 minutes and 108 ± 35 minutes, respectively. Average postoperative hospital stay was 10.3 ± 8.6 days. The most common early complications were postoperative pneumonia (26.1%) and junctional ectopic tachycardia (23.9%). Follow-up was conducted in all patients, with an average duration of 8.1 ± 4.3 months. At the last follow-up, right ventricular outflow tract pressure gradient decreased from 63 ± 23.2 mm Hg to 20 ± 9.8 mm Hg, and pulmonary valve annulus size increased from 8.7 ± 1.9 mm to 11.6 ± 1.8 mm. No deaths occurred during follow-up. Mild and moderate right ventricular outflow tract stenosis was observed in 22 (47.8%) and 2 (4.2%) patients, respectively. Moderate pulmonary valve regurgitation developed in 1 patient (2.1%). The early-term result of minimally invasive cardiac surgery in the treatment of TOF is relatively positive, making this a promising alternative to the traditional method. However, further practice in a narrow space is required to reach proficiency.