CARDIOVASCULAR JOURNAL OF AFRICA • Vol 23, No 2, March 2012
e10
AFRICA
genous flap from the pulmonary artery decreases the risk of
reoperation in the future.
The main disadvantage of this technique is the necessity for
a non-hypoplastic main pulmonary artery. Continuity between
the right ventriculotomy and the main pulmonary artery was
achieved through the flap produced from the main pulmonary
artery. Therefore the posterior wall of the main pulmonary artery
must be preserved for the integrity of the artery. This will ensure
sewing of the pericardial patch to both pulmonary arteries (the
flap and the
in-situ
posterior pulmonary artery).
In long-term follow up of TOF operations, intractable malign
arrhythmias and pulmonary insufficiency leading to right
ventricular dysfunction are the main problems that surgeons
face. Although the follow up in our patients was not long enough,
we detected pulmonary insufficiency in the short term. However,
we did not observe right ventricular dysfunction or arrhythmia in
any of our patients.
Conclusion
The ‘double-outflow’ technique is appropriate for TOF patients
with coronary artery anomalies, since it is easy to perform, has
no additional cost or the need for a conduit. The technique has
highly favorable outcomes; reoperation rates are low due to the
use of a tissue conduit which has the potential to grow. The tech-
nique can be applied to infants, so they are protected from the
deleterious effects of hypoxia.
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