EXPERIENCE OF EMERGENT RESTERNOTOMY OF TETRALOGY OF FALLOT IN CHILDREN

Jiang LJ, Zhang ZW

Affiliated Children's hospital, Medicine College of Zhejiang University, Hangzhou, China

Objective: To retrospective analyze the reasons of emergent resternotomy of tetralogy of fallot in children and to discuss the prevention and therapy of complications after resternotomy.

Metheds: From April 1990 to December 2000, 17 cases were undergone emergent resternotomy after primary repair of tetralogy of fallot in intensive care unit. Mean age at operation was 4.23(range, 8months to 11 years); mean cardiopulmonary bypass time was 162.2 minutes; mean cross-clamp times 99.1 minutes.

Results: It accounts for 34.3% of all the emergent resternotomies and 4.25% of all tetralogy of fallot undergone primary repair in the corresponding period. There is 4 death with the mortality 23.5%. Reasons for resternotomy included heart arrest (4 cases), cardiac tamponade (5 cases), hemorrhage (4 cases), sternum dehiscence (1 case), and low cardiac output syndrome (3 cases). The complications included central nervous system disorder (2cases), renal function failure (1 case), mediastinal infection (2 cases), atelectasis（1 case）.

Conclusions: early detection of the fluctuation of the postoperative hemodynamics and oxygen saturation is crucial to successful resternotomy. Attention should be paid to early and active protection to cerebral and renal function. It is also important to prevent mediastinal infection after resternotomy.

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