Clinical analysis and processing of early complications after complete repair of tetralogy of fallot

来源 :第八届北京五洲国际心血管病会议 | 被引量 : 0次 | 上传用户:caiqigang
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  Objective In order to reduce the incidence and mortality caused by early complications after complete repair of tetralogy of fallot (TOF), we summarized the relevant clinical experiences in daily practice.Methods We retrospectively reviewed the medical records of 188 patients receiving TOF resection during the period between January 2012 and December; 188 of them, 31 cases had complications and the remaining did not have.Demographic and clinical characteristics including age, weight, preoperative hemoglobin, oxygen saturation, McGoon, intraoperative cardiopulmonary bypass (CPB) time, aortic clamping time, postoperative ventilation time, ICU stay, positive inotropic agents score and right ventricular outflow tract pressure difference were compared between the two groups.Results There were significant difference between the complication and non-complication groups in terms of post-operation McGoon (1.54 ± 0.21) vs.(2.01±0.42), intraoperative CPB time (112.54 ± 33.32) vs.(97.03±26.1) min, aortic clamping time (65.38 ± 15.41) vs.(61.87±15.38) min, postoperative ventilation time (85.64 ± 35.38 vs.44.62±21.84 h), guardianship chamber residence time 5.0(2.0,7.0) vs.3.0(1.0,5.0)d, inotropic score (18.21 ± 6.27) vs.(10.16±3.18) (P <0.05).Postoperative right ventricular outflow tract pressure difference 21.5 (12.3,33.8) vs.24.0 (17.0,32.0) mmHg, no significant difference between the complication group and non-complication group.Complications included low cardiac output syndrome (9 cases), capillary leak syndrome (12 cases), arrhythmia (5 cases), lung perfusion injury (2 cases) and infection (5 cases).A total of 5 patients (2.66%) died of complications.Conclusion Comprehensive measures including strictly control of surgical indications, shortening the duration of CPB and appropriate use of inotropic drugs following operations and active peritoneal dialysis where necessary are useful to prevent and control low cardiac output syndrome and leak syndrome after complete repair of TOF.In addition, mechanical ventilation PEEP therapy and High frequency ventilation can control most of perfusion lung.If necessary, interventional occlusion major aorto pulmonary collateral arteries.
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