Frequency of various cardiac complications in children with repaired tetralogy of Fallot identified, as identified by computer tomography

Abstract

Aim: To investigate the frequency of complications after a tetralogy of Fallot (ToF) repair (rToF) in pediatric patients, as detected through computed tomography (CT). Methods: A retrospective analysis of 613 patients with ToF was carried out from October 2011 to June 2020. A total of 116 patients (69 male and 47 female), with complications after a rToF (as identified by CT), were included in this study. When rToF was performed, the patients average age ranged from 10 to 36 months (mean 12 months), average body weight was 21 kg, average height was 105.4 cm, and average body surface area (BSA) was 0.74 m2. The patients median age at the time of the CT examination was 17.5 years (age range: 736 years). Results: Of a total of 116 patients that exhibited complications after an rTOF, 49 had a pulmonary artery (PA) stenosis, 92 had a PA branch stenosis (56 of them of the left main PA branch (LPA), and 36 of them of the right main PA branch (RPA)), 8 had a right ventricular outflow tract (RVOT) stenosis, 32 had a ventricular septal defect, 1 had a shunt thrombosis, 12 had a postoperative deformation of the PA, 10 exhibited a marked right ventricular dilatation, 2 had an RVOT aneurysm, and 6 suffered from conduit calcification and stenosis. Moreover, there was a 6.5 times greater chance of developing an RPA stenosis in patients with an LPA stenosis (p 0.001). Conclusions: The most frequently CT-detected complications after a rToF were PA stenosis and PA branch stenosis. Patients with PA and PA branch stenosis exhibit no significant differences in terms of age, anthropometric parameters (height, weight, and BSA), and gender distribution in the presence or absence of different stenosis types (PA, RPA, or LPA). However, an RPA stenosis increases the chances of developing an LPA stenosis.