Abstract:
Introduction. Tetralogy of Fallot (TOF) is found in about 1 in 3600 live births, constituting 5.5 - 9.7% of
all congenital heart malformations and is known as the most common cyanotic congenital heart disease.
TOF is the most common congenital cyanotic malformation - 50 - 70%. Although the mortality rate in
untreated patients reaches 50% by age of 6, currently there are multiple surgical procedures that correct the
TOF and ensure a long-term survival and a good quality of life.
Aim of study. The main objective of this study is to compare the early mortality rate of total repair of TOF,
TOF with DORV and palliative procedures between other hospitals and Timofei Moșneaga Republican
Clinical Hospital.
Methods and materials. This comparative study is based on an evaluation using a retrospective cohort
study of 369 patients results of total repair of TOF, TOF with DORV and palliative surgeries from the
Database of Cardiothoracic Surgery within the Timofei Moșneaga Republican Clinical Hospital and a
literature review of topic related articles selected from PubMed. Between 2002 and 2022, 396 patients
diagnosed with TOF underwent a total repair of TOF, total repair of TOF with DORV and palliative shunts
at Timofei Moșneaga Republican Clinical Hospital. The articles were selected from PubMed that contains
citations for biomedical literature from MEDLINE, life science journals, and online books. Studies that
were found to be the most relevant for this comparative study of early deaths in patients with TOF. The
statistical analysis was performed using Windows Chart and Excel.
Results. Because of lack of data, the analysis of early deaths of patients operated at Timofei Moșneaga
Republican Clinical Hospital can be compared only to the study conducted by Al Habib HF. Analyzing the
early death percentages we can conclude that palliative shunts performed at Timofei Moșneaga Republican
Clinical Hospital had a lower mortality rate to the ones presented in Al Habib HF study. The early death
percentages in palliative procedure of TOF are quite similar in both 3.03% at Timofei Moșneaga Republican
Clinical Hospital and 3.22% in Al Habib HF study. Another interesting observation is that early deaths post
TOF total repair had a higher mortality rate at Timofei Moșneaga Republican Clinical Hospital, whereas it
is the other way in Al Habib HF study.
Conclusion. The short term death rate of patients with diagnosed TOF without any further surgical
operation is as high as 50%, but with a total correction of TOF, TOF with DORV or palliative shunt the
early death percentage was lowered to 5.05% at Timofei Moșneaga Republican Clinical Hospital, making
it a satisfactory outcome. This huge improvement in early survival rate must also have a big impact on later
risk of death for adults with repaired TOF. Compared to other studies Park CS, Al Habib HF and Bacha
EA the early death outcome results at Timofei Moșneaga Republican Clinical Hospital are satisfactory.
