Primary early correction of tetralogy of Fallot irrespective of age
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Primary early correction of tetralogy of Fallot irrespective of age. / Kantorova, Andrea; Zbieranek, Kai; Sauer, Henning; Lilje, Christian; Haun, Christoph; Hraska, Viktor.
In: CARDIOL YOUNG, Vol. 18, No. 2, 04.2008, p. 153-157.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Primary early correction of tetralogy of Fallot irrespective of age
AU - Kantorova, Andrea
AU - Zbieranek, Kai
AU - Sauer, Henning
AU - Lilje, Christian
AU - Haun, Christoph
AU - Hraska, Viktor
PY - 2008/4
Y1 - 2008/4
N2 - OBJECTIVE: The policy of early repair of patients with tetralogy of Fallot, irrespective of age, as opposed to initial palliation with a shunt, remains controversial. The aim of our study was to analyze the midterm outcome of primary early correction of tetralogy of Fallot.METHODS: Between 1996 and 2005, a total of 61 consecutive patients less than 6 months of age underwent primary correction of tetralogy of Fallot in two institutions. The median age at surgery was 3.3 months, and 27 patients (44%) were younger than 3 months of age, including 12 (20%) newborns. We analyzed the patients in 2 groups: those younger than 3 months of age, and those aged between 3 and 6 months.RESULTS: There was one early (1.6%), and one late death. Actuarial survival was 98.4%, 96.7%, 96.7% at 1, 5, and 10 years respectively, with a median follow up of 4.5 years. There was no difference in survival, bypass time, lengths of ventilation, and hospital stay between the groups. A transjunctional patch was placed significantly more often in the patients younger than 3 months (p = 0.039), with no adverse effect on survival and morbidity during the follow-up. Freedom from reoperation was 98.2%, 92.2%, and 83% at 1, 5, and 10 years respectively, with no difference between the groups.CONCLUSION: Elective primary repair of tetralogy of Fallot in asymptomatic patients is delayed beyond 3 months of age. In symptomatic patients, primary repair of tetralogy of Fallot is performed irrespective of age, weight and preoperative state. This approach is safe, and provides an excellent midterm outcome with acceptable morbidity and rates of reintervention. The long-term benefits of this approach must be established by careful follow-up, with particular emphasis on arrhythmias, right ventricular function, and exercise performance.
AB - OBJECTIVE: The policy of early repair of patients with tetralogy of Fallot, irrespective of age, as opposed to initial palliation with a shunt, remains controversial. The aim of our study was to analyze the midterm outcome of primary early correction of tetralogy of Fallot.METHODS: Between 1996 and 2005, a total of 61 consecutive patients less than 6 months of age underwent primary correction of tetralogy of Fallot in two institutions. The median age at surgery was 3.3 months, and 27 patients (44%) were younger than 3 months of age, including 12 (20%) newborns. We analyzed the patients in 2 groups: those younger than 3 months of age, and those aged between 3 and 6 months.RESULTS: There was one early (1.6%), and one late death. Actuarial survival was 98.4%, 96.7%, 96.7% at 1, 5, and 10 years respectively, with a median follow up of 4.5 years. There was no difference in survival, bypass time, lengths of ventilation, and hospital stay between the groups. A transjunctional patch was placed significantly more often in the patients younger than 3 months (p = 0.039), with no adverse effect on survival and morbidity during the follow-up. Freedom from reoperation was 98.2%, 92.2%, and 83% at 1, 5, and 10 years respectively, with no difference between the groups.CONCLUSION: Elective primary repair of tetralogy of Fallot in asymptomatic patients is delayed beyond 3 months of age. In symptomatic patients, primary repair of tetralogy of Fallot is performed irrespective of age, weight and preoperative state. This approach is safe, and provides an excellent midterm outcome with acceptable morbidity and rates of reintervention. The long-term benefits of this approach must be established by careful follow-up, with particular emphasis on arrhythmias, right ventricular function, and exercise performance.
KW - Age Factors
KW - Chi-Square Distribution
KW - Female
KW - Humans
KW - Infant
KW - Infant, Newborn
KW - Male
KW - Postoperative Complications
KW - Reoperation
KW - Retrospective Studies
KW - Risk Factors
KW - Survival Rate
KW - Tetralogy of Fallot/surgery
KW - Treatment Outcome
U2 - 10.1017/S1047951108001960
DO - 10.1017/S1047951108001960
M3 - SCORING: Journal article
C2 - 18252030
VL - 18
SP - 153
EP - 157
JO - CARDIOL YOUNG
JF - CARDIOL YOUNG
SN - 1047-9511
IS - 2
ER -