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TOFPA: A Surgical Approach to Tetralogy of Fallot with Pulmonary Atresia

TOFPA: A Surgical Approach to Tetralogy of Fallot with Pulmonary Atresia

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Published by Redmond P. Burke MD
Redmond Burke MD, Chief of Pediatric Cardiovascular Surgery at Miami Children's Hospital, describes our program's approach to patients with TOF/PA.
Redmond Burke MD, Chief of Pediatric Cardiovascular Surgery at Miami Children's Hospital, describes our program's approach to patients with TOF/PA.

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Published by: Redmond P. Burke MD on Apr 25, 2011
Copyright:Attribution Non-commercial

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12/27/2012

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TOF/PA with well developedTOF/PA with well developedcentral pulmonary arteriescentral pulmonary arteries
Primary complete repair Primary complete repair 
Redmond P. Burke
Chief, Division of Cardiovascular SurgeryThe Congenital Heart InstituteMiami Children¶s Hospital and Arnold Palmer Hospital
Cara Guenther 
Undergraduate Fellow
www.pediatricsurgery.com
 
W
hat
W
hatis TOF/PA?is TOF/PA?
Children with TOF/PA illustrate theChildren with TOF/PA illustrate thefollowing four characteristics:following four characteristics:
 A hole in the ventricular septum (VSD) A hole in the ventricular septum (VSD)
 An anterior shift of the aorta, resulting in an aorta that An anterior shift of the aorta, resulting in an aorta thatlies above the VSD (lies above the VSD (³³overriding aortaoverriding aorta´´))
Obstruction of right ventricular outflow (pulmonaryObstruction of right ventricular outflow (pulmonaryatresia)atresia) ± ±smaller pulmonarysmaller pulmonary artery,artery, and muscular and muscular  narrowing below the valvenarrowing below the valve
Thickening of the right ventricle (ventricular Thickening of the right ventricle (ventricular hypertrophy) since the heart has to pump harder tohypertrophy) since the heart has to pump harder tocompensate for the pulmonary atresiacompensate for the pulmonary atresia
Info from: http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/AboutCongenitalHeartDefects/Tetralogy-of-Fallot_UCM_307038_Article.jsp
 
N
ormal Heart vs. Heart with
N
ormal Heart vs. Heart withTOF/PATOF/PA
N
ormal HeartHeart with TOF/PA*
Please note the intact ventricular septum, thelocation of the aorta, the size of and flow throughthe pulmonary artery, and the thickness of theright ventricular muscle*Please note 1) pulmonaryatresia, 2) right ventricular hypertrophy 3) overriding aortaand 4) VSD
Info from:http://kardiol.com/?p=263and http://www.nhlbi.nih.gov/health/dci/Diseases/tof/tof_what.html

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Redmond P. Burke MD added this note
Congratulations to Cara Guenther, our Undergraduate Fellow from Harvard University. She did a great job with this presentation.
Redmond P. Burke MD added this note
We have uploaded a video of our surgical technique for TOF/PA to YouTube http://www.youtube.com/watch?v=Pj2heH...

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