Tetralogy of Fallot in the nascent open-heart surgical era in a tertiary hospital in south-west Nigeria: lessons learnt

Cardiovasc J Afr. 2022;33(3):122-126. doi: 10.5830/CVJA-2021-048. Epub 2021 Nov 22.

Abstract

Background: Tetralogy of Fallot (TOF) is the leading cyanotic congenital heart disease. We commenced open-heart surgery at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Nigeria in 2016.

Objectives: To review the incidence, pattern, management and treatment outcomes of TOF at the OAUTHC.

Methods: A retrospective audit was undertaken of hospital records, including echocardiograms of patients with TOF seen from January 2016 to February 2020 at the Paediatric Cardiology Unit, OAUTHC.

Results: Seventy-two patients (37 boys and 35 girls) aged 0.17-22 years had TOF. Thirty-three (45.8%) had surgery; 31 (93.9%) corrective surgery and two (6.1%) a modified Blalock-Taussig shunt. Complications following surgery included cardiac dysfunction, post-transfusion malaria, pulmonary regurgitation, pericardial effusion and death (15%). Thirty-nine (54.2%) patients had conservative medical management. Complications included polycythaemia and thrombotic stroke, and 14 (35.9%) patients died.

Conclusions: TOF is associated with significant morbidity and mortality in developing countries. Early and safe corrective surgery is desirable.

Keywords: congenital heart disease; conservative approach outcome; echocardiography; follow‐up results; surgical outcome; surgical repair; tetralogy of Fallot.

MeSH terms

  • Blalock-Taussig Procedure*
  • Child
  • Female
  • Humans
  • Infant
  • Male
  • Nigeria / epidemiology
  • Retrospective Studies
  • Tertiary Care Centers
  • Tetralogy of Fallot* / complications
  • Tetralogy of Fallot* / diagnostic imaging
  • Tetralogy of Fallot* / surgery
  • Treatment Outcome