Behavioral Development is better after Early Repair of Tetralogy of Fallot

Abstract

Psychological development of patients with surgically corrected Tetralogy of Fallot could be affected by the chronic preoperative cerebral hypoxia; therefore early repair is beneficial for the outcome of these patients. 71 Tetralogy of Fallot patients were operated in Heart Institute between September 1st, 2001 and July 1st, 2006, all of them underwent corrective surgery, without prior palliations. Corrective surgery consisted of: transannular patch (46), infundibular patch – PA patch (17), and transatrial and transpulmonary correction (8). The patients were divided into 2 groups, correction below age of 1 year and above 1 year, for comparative study of results. 13 patients were excluded for various reasons, and 58 patients were followed up, at 82.66?17.269 months, performing a Child Behavior Check List test. All the components of CBCL test were studied comparatively between the 2 groups: affectivity, anxiety, somatic, ADHD, opposing behavior and conduct problems, as absolute values and divided into normal, subclinical and clinical levels. Major differences were noticed between the two groups, as followed: affectivity and anxiety values (absolute values and normal, subclinical and clinical levels) were higher in patients operated after 1 year of age. Interestingly, affective and anxiety problems and opposing behavior were also correlated (statistically significant) with the preoperative hematocrit. Delay in surgical correction beyond 1 year of age in patients with Tetralogy of Fallot could have deleterious effects over psychological development (affective, anxiety, somatic, ADHD, opposing behavior and conduct problems) of these patients, due to longer period of preoperative chronic cerebral hypoxia.