GREAT ARTERY RATIO: DOES IT REALLY MATTERS IN TOTAL CORRECTION OF TETRALOGY OF FALLOT?

Abstract

Objective: To investigate the significance of Great artery ratio, for decision of right ventricular outflow tract management in patients with Tetralogy Of Fallot. Methodology: A retrospective cross sectional study including surgical record ofpatients operated for total correction of Tetralogy Of Fallot from January 2015 toDecember 2015 in Department of Paediatric cardiac surgery NICVD, was done.Patients whose aortic annuals were documented in record were included instudy. A relation of great artery ratio with cut off value of 0.55 with Trans AnnularPatch Enlargement Repair and patient outcome as defined by time of extubationlesser or greater than six hours and survival after surgery was evaluated. Datawas analysis on SPSS 21. Results: Of total 66 patients, male were 66.7%. Great artery ratio of 0.55 or lesswas calculated in 39.4% of patients, while trans annular patch enlargementrepair of Tetralogy Of Fallot (TOF) was observed in 15% of patients with 6 patientsin GA ratio 0.55 or less required trans annular patch enlargement compared to 4patients in GA ratio of >0.55( p=0.14 ). However a significant association ofmortality was observed with 15.4% of patients expired in group with low GARatio compared to no mortalities in patients with GA ratio of >0.55 (p<0.05). Conclusion: Although Trans annular patch enlargement with low GA ratio wasrequired in very few patients but it was associated with decreased survival.