Tetralogy of Fallot (TOF) is a common cyanotic congenital heart disease. Its surgical correction requires ventricular septal defect (VSD) closure and right ventricular outflow tract obstruction (RVOTO) relief, with transannular patch enlargement (TAPE) of the pulmonary valve. The first successful repair of TOF was reported in 1954 and consisted of closure of the VSD through a large right ventriculotomy, and RVOTO relief with TAPE of the pulmonary valve. To predict the intra-operative requirements and post-operative course of patients with this condition, various evaluation indices are available that can provide a good indication of patient prognosis. In this case report, we describe a novel pulmonary vein index (PVI) indicator that offers prognostic indications for pediatric cardiac patients who have undergone surgical correction of TOF.

IntroductionSinus venosus atrial septal defects (SVASDs), originally described in 1858, account for approximately 4%-11% of all atrial septal defects (ASDs)[1,2]. The typical SVASD is an interatrial communication that results from a deficiency of the common wall between the superior vena cava (SVC) and the right-sided pulmonary veins[2,3]. SVASD is commonly associated with anomalous pulmonary venous connections (APVCs) involving some or all of the pulmonary veins[3,4], which produces additional left-to-right shunting. The basic principle of repair is redirection of the APVC through the interatrial communication into the left atrium.In contrast to operative repair of secundum ASD, the surgical approach for SVASD is more complex and carries the risk of stenosis of the SVC or pulmonary veins, residual shunting, and sinus node dysfunction[4].We reviewed outcomes for patients who underwent SVASD repair at Bhanubhai and Madhuben Patel Cardiac Centre, Karamsad, Anand, Gujarat, India, with a focus on patient survival and development of arrythmias.