Sung technique versus conventional trans annular patch augmentation of right ventricular outflow tract in Tetralogy of Fallot

The objective of this study was to compare the outcomes of repairing Tetralogy of Fallot (TOF) using two different techniques: trans-annular patch alone versus pulmonary valve cusp augmentation (Sung technique) with pericardium. A total of sixty TOF patients underwent successful surgical repair using either the traditional trans-annular patch or Sung’s technique. Parameters such as postoperative use of inotropes, duration of recovery, and residual pulmonary insufficiency (PI) were compared between the two groups. The results showed that the age, weight, pulmonary valve annulus diameter, and Nakata index were similar in both groups. The mean aortic clamp time and median cardiopulmonary bypass time were also comparable. However, the patients who underwent Sung’s repair had a lesser requirement for inotropes and faster recovery compared to the trans-annular patch group. Postoperative 2D echocardiography revealed a lower incidence of moderate or more pulmonary insufficiency in patients who underwent Sung’s pulmonary valve augmentoplasty. Based on these findings, it was concluded that the augmentation of the pulmonary valve cusp reduces the occurrence of clinically significant postoperative pulmonary insufficiency. Therefore, this technique may improve the early outcome for patients with TOF who require a trans-annular patch.