Case report: tetralogy of Fallot - complete repair

Abstract

Introduction: Tetralogy of Fallot is a complex malformation, with a frequency of 10% of the ACC. It is characterized by the presence of four elements: ventricular septal defect located above, pulmonary stenosis (at the infundibulum, valve or pulmonary artery), dextraposition of aorta and right ventricular hypertrophy. It can be associated with coarctation of the aorta, atrial septal defect, patent ductus arteriosus and left superior vena cava. Material and Methods: Child, 5 years old, from rural areas, symptomatic by low threshold exertional dyspnea, with generalized cyanosis and a history of multiple episodes of respiratory infections, diagnosed postnatally with Tetralogy of Fallot. The clinical and paraclinical examinations (ECG, Chest X-ray, Echo and cardiac catheterization) performed in our clinic confirm the diagnosis of Tetralogy of Fallot associated with patent foramen ovale. Surgical treatment consisted of: closing of the ventricular septal defect with a Dacron patch via the tricuspid valve with separate threads with patches, closure of the patent foramen ovale, infundibular segmental resection and enlargement of the pulmonary artery trunk with autologous pericardial patch. Results: Postoperative evolution was slowly favorable. Postoperative com plications were: kidney failure, liver failure, chylothorax and febrile syndrome. These complications have been successfully treated in the ICU unit. Currently the patient has a good general condition, there is no residual exertional dyspnea or cyanosis. Conclusion: Tetralogy of Fallot is a congenital heart disease that can be successfully treated if a correct diagnosis is made preoperatively, followed by using appropriate surgical techniques and a rigorous monitoring and management in the postoperative period.