Authors : Gamal A Abdelhameed, Waleed I Ibraheem, Samar M Abdeltawab, Simon H Armanios
DOI : 10.18231/j.ijca.2020.006
Volume : 7
Issue : 1
Year : 2020
Page No : 23-31
Objective(s): To study the relation between the systolic and diastolic right ventricular (RV) function in
relation to the time of extubation after total repair of tetralogy of Fallot (TOF) in a pediatric population.
Design: Prospective, descriptive, non-randomized study.
Setting: Pediatric cardiac surgery unit at Ain Shams University Hospitals, Cairo, Egypt. The study was
conducted from January 2016 to February 2018.
Participants: A total of 60 patients having elective primary total repairs of TOF made up the study sample.
The patients were divided into two groups based on the time of extubation: Group I included patients who
were extubated 6 hours or more after the procedure, while Group II included patients who were extubated
within the first 6 hours.
Interventions: Total corrective surgery involving open-heart surgery with cardiopulmonary bypass.
Measurements and Main Results: Early outcomes of mortality and morbidity were evaluated. RV systolic
and diastolic functions were evaluated in the routine echocardiography performed on the first and fifth
postoperative days. Additionally, patients’ inotropic drug requirements during their intensive care unit
(ICU) stays were calculated to produce the inotropic index for evaluation of postoperative low cardiac
output. Group I contained 32 patients, while Group II contained 28. The mean ages in Group I and II,
respectively, were 1.2 0.8 years and 1.5 0.9 years (p = 0.180). The mean weight in Group I and II,
respectively, was 10.5 2.5 kg and 9.86 3.2 kg (p = 0.396). There were 20 (62.5%) males in Group
I and 18 (64.29%) males in Group II (p = 0.886). Mortality was 2 cases (6.3%) in Group I and 1 case
(3.6%) in Group II, with no statistical difference. Postoperative echocardiographic examination revealed
significantly better RV functional parameters in Group II than in Group I.
Keywords: Early extubation, Right ventricular function, Tetralogy of Fallot.