Postoperative Complications Following Total Surgical Correction of Tetralogy of Fallot: A Retrospective Cross-Sectional Study.

Abstract

Background: Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart defect. Total surgical correction remains the definitive treatment. Despite improvements in surgical techniques, postoperative complications are still reported and vary in severity. Understanding these complications is crucial for improving surgical outcomes and postoperative care. To determine the frequency and types of in-hospital postoperative complications following total surgical correction of Tetralogy of Fallot.

Methodology: This retrospective cross-sectional study was conducted at the Department of Cardiovascular Surgery, Lady Reading Hospital, Peshawar, from January 2010 to December 2020. A total of 150 patients who underwent complete surgical correction for TOF were included using non-probability consecutive sampling. Patients aged 3 to 25 years of both genders were enrolled. Data were collected from hospital records and analyzed using SPSS version 20.

Results: A total of 150 patients were included, with a mean age of 6.5 ± 2.9 years (range: 3–25 years). Males constituted 60% (n = 90) of the study population. Isolated TOF was present in 55% of the patients, while 45% had associated anomalies, such as patent foramen ovale (PFO), atrial septal defect (ASD), patent ductus arteriosus (PDA), right-sided aortic arch, and left superior vena cava (SVC). The most frequently observed postoperative complications included heart failure (12%), postoperative bleeding, and conduction abnormalities. Complete heart block, the most common conduction disturbance, was observed in 5 cases (3.3%). Pleural effusion and pneumothorax were also documented but occurred less frequently.

Conclusion: Postoperative complications following total correction of Tetralogy of Fallot are not uncommon. The most frequently observed complications in this study were bleeding, heart failure, complete heart block, and pneumothorax. Early identification and management of these complications are essential to improving patient outcomes.