The Predicament of Surgical Correction of Tetralogy of Fallot
| Autor: | Amir-Reza Hosseinpour, Siew Yen Ho, Alejandro Adsuar-Gómez, Antonio González-Calle |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Ventricular outflow tract Humans Treatment Failure Normal heart Tetralogy of Fallot business.industry Palliative Care Infant Vascular surgery Surgical correction medicine.disease Prognosis Cardiac surgery Review article medicine.anatomical_structure 030228 respiratory system Ventricle Pediatrics Perinatology and Child Health cardiovascular system Cardiology Cardiology and Cardiovascular Medicine business |
| Zdroj: | Pediatric cardiology. 42(6) |
| ISSN: | 1432-1971 |
| Popis: | Surgery for tetralogy of Fallot has a long history, which may be described as both a success story and a failure story. It is a success story because prognosis without surgery is very poor, but surgery makes it possible for affected babies to reach adulthood and lead productive lives. It is a failure story, however, since we still cannot cure this condition; we can only palliate it as illustrated in the sobering long-term outcome of affected patients. In this review article, we aim to explore the reason for this failure. This may be summed up in terms of the nature of the obstruction to the right ventricular outflow tract, which characterizes this malformation and must be relieved. This obstruction has several possible components, but none may be eliminated without harming the ventricle. There seems to be no 'extra' muscle band in tetralogy of Fallot that may be dispensed with without undermining ventricular function; every muscle band that is there should be there, just like in the normal heart, except that these are thicker than normal and somewhat displaced in tetralogy of Fallot, thus narrowing the right ventricular outflow tract. Consequently, ventricular function deteriorates with every muscle band that is cut, just like in the normal heart. We have to harm the heart in order to repair it. Every repaired Fallot is inevitably a damaged heart. Consequently, repair of this condition cannot be curative at present; it is palliative surgery. |
| Databáze: | OpenAIRE |
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