الفهرس 
Historical PerspectivesOnly 14 pages are availabe for public view
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Abstract
Background and objectives
Because of the high incidence of Tetralogy of Fallot and the different techniques for the surgical management with the end of the palliative surgical procedures, a new era developed that gave a favorable results, but still there is a debate about the proper technique to relieve the Right Ventricular Outflow Tract Obstruction which leads to less mortality and morbidity, so it was necessary to analyse data that compare these different techniques.
In this study a meta-analysis was done to compare between the two most common techniques that are used to relieve the RVOT those are Transannular patch VS Valve Sparing Repair. The variables choices include: Mortality, the Indexed Right Ventricular Volumes, QRS duration, incidence of pulmonary regurgitation, Right ventricular Ejection Fraction, Left Ventricular Ejection Fraction and incidence of Reoperation. The principal summary measures were difference in means with 95% confidence interval and p value (to be of significant if p < 0.005). The difference in means were combined across studies with MedCalc© version 15.8 (MedCalc© Software bvba, Ostend, Belgium).
Methodology
The study included 1090 patients from 12 studies undergone complete surgical Repair of Tetralogy of fallot either with TAP or Valve sparing techniques. Studies that was eligible were collected and analysed the results was compared according to: patient mortality, Indexed Right Ventricular Volumes assessed with cardiac MRI, Right Ventricular Ejection Fraction, QRS duration and LV EF.
Results:
A total of 72 citation were identified of which 20 studies were potentially relevant and retrieved in full text only 12 studies fulfilled the eligibility criteria There was 74% of patients had a TAP and 26% of patients had VSR. Mortality was 291 among patients with patch repair and 104 among valve sparing repair. Reoperation was detected in 7 patients with TAP VS 6 patients in VSR. Occurrence of PR was detected in 14 patients in TAP VS 12 patients in VSR. The study detected favorable measures in Indexed right ventricular volumes, RV ejection fraction and QRS duration in patients with VSR than those with TAP. This study detected that both group of patients had approximately equal results of LV ejection fraction.
Conclusion:
Our results reflected that Valve Sparing Repair for pediatric patients has better outcome in Mortality to relieve pulmonary stenosis, occurrence of pulmonary valve regurgitation and also has less harmful effect on the right ventricular ejection fraction, better Indexed right ventricular volume and QRS duration than using transannular patching technique.
Both transannular patching and valve sparing repair have approximately the same effect on the left ventricular ejection fraction that may need further studies.