GW24-e3832 Transcatheter closure of residual fistula after repair of tetralogy of fallot

Objectives To summarise the experience in transcatheter closure of residual fistula after surgery repair of tetralogy of Fallot (TOF). Methods Between January 2010 and November 2012, transcatheter closure was attempted on 9 (5 male, 4 female) patients, with residual membrane ventricular septal fistula following surgery repair of TOF. The mean age of patients was 15.68 ± 5.20 years (range from 4 to 36). Results 9 patients, diagnosed with TOF, underwent surgery repair. In two cases, the diameter of residual fistula was 6 mm and 5 mm measured by echocardiography after 1 month’s follow-up. 3 cases were found with systolic murmurs at 1 and 2-year follow-up respectively, with the size of fistula 7, 6, 9 mm and 8, 7, 8 mm. Another 1 case suffered from dyspnea 10 years after surgery, with a fistula of10 mm. Complete closure of the defect was obtained in 7 cases (77.78%), except that 2 patients required reoperation because of multiple outlet showed by left ventriculography. 5 cases were implanted with domestic symmetric VSD occluder (1 with 2 occluders), the other 1 case with thin-waist-big-side occluder and another 1 with patent ductus arteriosus (PDA) occluder. No patient had obvious complications related. Conclusions Transcatheter closure of residual fistula after surgery repair of TOF is effective and safe. Domestic VSD occluder and PDA occluder are applicable. It is important to prevent intraoperative injuries of muscle girder and chordae tendineae blocked by track wire and sheath.