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Cited by 176Congenital Heart Disease StudiesCongenital heart defects researchCardiovascular Conditions and Treatments

Long-term Outcomes of Tetralogy of Fallot: A Study From the Pediatric Cardiac Care Consortium

Open access
Smith, Clayton A., McCracken, Courtney, Thomas, Amanda S., Spector, Logan G., St Louis, James D., Oster, Matthew E., Moller, James H., Kochilas, Lazaros·2019·JAMA Cardiology
DOI 10.1001/jamacardio.2018.4255PMC PMC6439686
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Abstract

Multicenter retrospective cohort of 3,283 patients who survived repair for simple TOF; 25-year survival after repair was 94.5%, with analysis of patient- and surgery-associated risk factors affecting survival.

Integrity signals

Registry

Crossref · 10.1001/jamacardio.2018.4255

Cites

28 of 28 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

11 of 22 cited sources checked · 4 supported · 1 flagged · accuracy not yet measured

  • Study design and conductcitation

    There are important limitations in the use of NDI for ascertainment of COD.

    “There are also important limitations in the use of NDI for ascertainment of COD as highlighted by some comparison studies of assigned COD between NDI-based vs direct review methods.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [27] 27. Olubowale OT, Safford MM, Brown TM, et al. Comparison of expert adjudicated coronary heart disease and cardiovascular disease mortality with the national death index: results from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study. J Am Heart Assoc. 2017;6(5): e004966. doi:10.1161/JAHA.116.004966 source
  • Premisecitation

    NDI data tended to overestimate coronary disease as the COD, especially in older patients with multiple comorbidities.

    “More specifically, NDI data tended to overestimate coronary disease as the COD, especially in older patients with multiple comorbidities.27”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [27] 27. Olubowale OT, Safford MM, Brown TM, et al. Comparison of expert adjudicated coronary heart disease and cardiovascular disease mortality with the national death index: results from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study. J Am Heart Assoc. 2017;6(5): e004966. doi:10.1161/JAHA.116.004966 source

      The Discussion reports that older participants were more likely to have a CHD death recorded by NDI when expert adjudicators found another cause. It does not support the added claim that this occurred especially in patients with multiple comorbidities; it instead says disagreement was less likely among participants with a history of CHD or CVD. The Discussion also reports similar overall mortality rates despite classification discrepancies, so the overestimation finding is best confined to older participants. (LLM, conf=0.88)

      Experimental — accuracy not yet measured
  • Study design and conductcitation

    Linkage of the PCCC to the registries of the National Death Index (NDI) and the Organ Procurement and Transplantation Network (OPTN) extends the follow-up time of PCCC-enrolled persons for major outcomes with nearly 90% sensitivity and almost 100% specificity for death and transplant events.

    “Linkage of the PCCC to the registries of the National Death Index (NDI) and the Organ Procurement and Transplantation Network (OPTN) extends the follow-up time of PCCC-enrolled persons for major outcomes with nearly 90% sensitivity and almost 100% specificity for death and transplant events.14,15”
    Quote in the paperSubstantial claim2 of 2 sources checked
    • cites [14] 14. Spector LG, Menk JS, Vinocur JM, et al; In-Hospital Vital Status and Heart Transplants After Intervention for Congenital Heart Disease in the Pediatric Cardiac Care Consortium. In-hospital vital status and heart transplants after intervention for congenital heart disease in the pediatric cardiac care consortium: completeness of ascertainment using the National Death Index and United Network for Organ Sharing Datasets. J Am Heart Assoc. 2016;5(8):e003783. doi:10.1161/JAHA.116.003783 source

      Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

      Experimental — accuracy not yet measured
    • cites [15] 15. Spector LG, Menk JS, Knight JH, et al. Trends in long-term mortality after congenital heart surgery. J Am Coll Cardiol. 2018;71(21):2434-2446. doi:10. 1016/j.jacc.2018.03.491 source

      Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

      Experimental — accuracy not yet measured
  • Findingown data

    The high incidence of deaths from unintentional injury and suicides reported in the Taiwanese study was not confirmed in our cohort.

    “with the exception of the high incidence of deaths from unintentional injury and suicides, which were not confirmed in our cohort.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [10] 10. Chiu SN, Wang JK, Chen HC, et al. Long-term survival and unnatural deaths of patients with repaired tetralogy of Fallot in an Asian cohort. Circ Cardiovasc Qual Outcomes. 2012;5(1):120-125. doi: 10.1161/CIRCOUTCOMES.111.963603 source
  • Findingcitation

    The rates of sudden death and heart failure in our cohort are similar to those reported in other studies.

    “The rates of sudden death and heart failure in our cohort are similar to those reported in other studies.9,18”
    Quote in the paperNot a substantial claim2 of 2 sources checked
    • cites [9] 9. Nollert G, Fischlein T, Bouterwek S, Böhmer C, Klinner W, Reichart B. Long-term survival in patients with repair of tetralogy of Fallot: 36-year follow-up of 490 survivors of the first year after surgical repair. J Am Coll Cardiol. 1997;30(5):1374- 1383. doi:10.1016/S0735-1097(97)00318-5 source

      The Discussion (page unavailable) reports that sudden cardiac death remained the major cause of late death after tetralogy of Fallot repair. The follow-up passage (page unavailable) reports symptoms of congestive heart failure, but it does not establish a comparable heart-failure rate; the source also cannot assess similarity to the citing authors’ cohort. (LLM, conf=0.78)

      Experimental — accuracy not yet measured
    • cites [18] 18. Nørgaard MA, Lauridsen P, Helvind M, Pettersson G. Twenty-to-thirty-seven-year follow-up after repair for Tetralogy of Fallot. Eur J Cardiothorac Surg. 1999;16(2):125-130. doi:10.1016/ S1010-7940(99)00137-2 source

      The Discussion reports seven late sudden deaths and says that incidence was identical to that in another study. Table 1 lists deaths involving heart failure, but our copy does not compare heart-failure rates with other studies. Nor can this source establish whether either rate is similar to the citing authors’ own cohort. (LLM, conf=0.82)

      Experimental — accuracy not yet measured
  • May combine two claims. 24
  • Classified as probably not a substantial claim. 5

  • May combine two claims.

    Interpretationown data

    Earlier surgical eras had an inverse association with the chances of survival in the early postoperative phase, indicating higher residual postoperative morbidity, which is consistent with previous reports.

    “Earlier surgical eras had an inverse association with the chances of survival in the early postoperative phase, indicating higher residual postoperative morbidity, which is consistent with previous reports.8,9,17,19”
    Quote in the paperSubstantial claim1 of 4 sources checked
    • cites [8] 8. Hickey EJ, Veldtman G, Bradley TJ, et al. Late risk of outcomes for adults with repaired tetralogy of Fallot from an inception cohort spanning four decades. Eur J Cardiothorac Surg. 2009;35(1):156- 164. doi:10.1016/j.ejcts.2008.06.050 source
    • cites [9] 9. Nollert G, Fischlein T, Bouterwek S, Böhmer C, Klinner W, Reichart B. Long-term survival in patients with repair of tetralogy of Fallot: 36-year follow-up of 490 survivors of the first year after surgical repair. J Am Coll Cardiol. 1997;30(5):1374- 1383. doi:10.1016/S0735-1097(97)00318-5 source

      In “Survival according to date of operation” (page unavailable), the paper says operative and 1-year mortality were exactly the same before and after 1970. It reports improved long-term survival in the later era, not an early postoperative survival disadvantage in the earlier era; the passage does not establish higher residual postoperative morbidity. (LLM, conf=0.90)

      Checked by a reasoning model — may be wrong.

      Experimental — accuracy not yet measured
    • cites [17] 17. Cuypers JA, Menting ME, Konings EE, et al. Unnatural history of tetralogy of Fallot: prospective follow-up of 40 years after surgical correction. Circulation. 2014;130(22):1944-1953. doi:10.1161/ CIRCULATIONAHA.114.009454 source
    • cites [19] 19. Kim H, Sung SC, Kim SH, et al. Early and late outcomes of total repair of tetralogy of Fallot: risk factors for late right ventricular dilatation. Interact Cardiovasc Thorac Surg. 2013;17(6):956-962. doi: 10.1093/icvts/ivt361 source

  • May combine two claims.

    Premisecitation

    Prior studies detected no significant difference in long-term survival between patients treated with transannular patch (TAP) vs those with valve-sparing operation despite less valve replacements in the valve-sparing group.

    “In regards to the use of valve vs nonvalve-sparing approach, prior studies detected no significant difference in long-term survival between patients treated with transannular patch (TAP) vs those with valve-sparing operation despite less valve replacements in the valve-sparing group.23,24”
    Quote in the paperSubstantial claim1 of 2 sources checked
    • cites [23] 23. Kim GS, Han S, Yun TJ. Pulmonary annulus preservation lowers the risk of late postoperative pulmonary valve implantation after the repair of tetralogy of Fallot. Pediatr Cardiol. 2015;36(2):402- 408. doi:10.1007/s00246-014-1021-4 source
    • cites [24] 24. Luijten LW, van den Bosch E, Duppen N, et al. Long-term outcomes of transatrial-transpulmonary repair of tetralogy of Fallot. Eur J Cardiothorac Surg. 2015;47(3):527-534. doi:10.1093/ejcts/ezu182 source

  • May combine two claims.

    Interpretationcitation

    The difference in COD between our cohort and the Taiwanese study may be associated with local factors and the relatively small number of patients and death events in the Taiwanese study, limiting generalization for reported COD in categories with relatively rare events.

    “This difference may be associated with local factors and the relatively small number of patients and death events in the Taiwanese study, limiting generalization for reported COD in categories with relatively rare events.10”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [10] 10. Chiu SN, Wang JK, Chen HC, et al. Long-term survival and unnatural deaths of patients with repaired tetralogy of Fallot in an Asian cohort. Circ Cardiovasc Qual Outcomes. 2012;5(1):120-125. doi: 10.1161/CIRCOUTCOMES.111.963603 source

      Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

      Experimental — accuracy not yet measured

  • May combine two claims.

    Findingown data

    The most frequent causes of death outside CHD/CVD were external causes (n = 16 [11%]), other medical causes (n = 19 [13.1%]), other congenital anomalies (n = 10 [6.9%]), and neoplasms (n = 5 [3.5%]).

    “The most frequent CODs outside CHD/CVD were external causes (n = 16 [11%]), other medical causes (n = 19 [13.1%]), other congenital anomalies (n = 10 [6.9%]), and neoplasms (n = 5 [3.5%]).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Cardiovascular disease, without reference to TOF, accounted for 15.2% of deaths (n = 22), while 41.4% (n = 60) were assigned to a non-CHD/non-CVD condition.

    “Cardiovascular disease, without reference to TOF, accounted for 15.2% of deaths (n = 22), while 41.4% (n = 60) were assigned to a non-CHD/non-CVD condition.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Three thousand one hundred sixty-eight underwent primary repair, while 726 had a staged approach with initial shunt followed by repair.

    “Three thousand one hundred sixty-eight underwent primary repair, while 726 had a staged approach with initial shunt followed by repair.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    In-hospital mortality following TOF repair occurred more commonly in infants, patients weighing less than 2.5 kg at repair, patients with prior shunt palliation, in earlier surgical eras (1982-1989 and 1999-2000), and concurrent genetic syndrome.

    “In-hospital mortality following TOF repair was 4.1% and occurred more commonly in infants, patients weighing less than 2.5 kg (proxy for prematurity) at repair, patients with prior shunt palliation, in earlier surgical eras (1982-1989 and 1999-2000), and concurrent genetic syndrome (Table 1).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Over a median follow-up period of 18.5 years (maximum, 33 years; IQR, 14.6-22.4 years), 145 deaths (3 following transplant) and 5 transplants occurred.

    “Over a median follow-up period of 18.5 years (maximum, 33 years; IQR, 14.6-22.4years), 145 deaths (3 following transplant) and 5 transplants occurred.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    A more rapid early mortality was noted for those who underwent repair in the earliest era, but long-term survival was similar across all eras.

    “A more rapid early mortality was noted for those who underwent repair in the earliest era, but long-term survival was similar across all eras (Figure 2F).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    There is a trend toward increased mortality in the subgroup undergoing right ventricle-pulmonary artery conduit placement, at a time when procedures for an outgrown conduit are expected to take place, but the relatively small number of this group limits conclusions.

    “There is also a trend toward increased mortality in the subgroup undergoing right ventricle-pulmonary artery conduit placement, at a time when procedures for an outgrown conduit are expected to take place, but the relatively small number of this group limits conclusions.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    During the study period, there was a trend toward earlier primary repair (aged <1 year), but otherwise, there was no significant difference in the use of staged vs primary repair or between valve-sparing vs non-valve-sparing strategies.

    “During the study period, there was a trend toward earlier primary repair (aged <1 year), but otherwise, there was no significant difference in the use of staged vs primary repair or between valve-sparing vs non-valve-sparing strategies (eTable 1 in the Supplement).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Of the 3733 discharged alive, 3283 patients had direct identifiers available and compose the cohort submitted to the NDI/OPTN, while 450 had insufficient identifiers and were excluded.

    “Of these, 3283 patients had direct identifiers available and compose the cohort submitted to the NDI/OPTN, while 450 had insufficient identifiers and were excluded.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The subgroup repaired with a right ventricle-pulmonary artery conduit (n = 88) experienced a higher number of deaths 2 to 4 years after TOF repair compared with the other non-valve-sparing patients, but the number of events is too small to detect a significant difference in long-term survival.

    “This group experienced a higher number of deaths 2 to 4 years after TOF repair compared with the other non-valve-sparing patients, but the number of events is too small to detect a significant difference in long-term survival (eFigure 2 in the Supplement).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    In the PCCC cohort, the late-phase survival and cause of death have not substantially changed over time.

    “In the PCCC cohort, the late-phase survival and COD have not substantially changed over time.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The trough of the hazard function is around 6 years followed by a slow steady increase throughout the follow-up period.

    “Insert: zoomed view of the hazard function that shows the trough of the hazard around 6 years followed by a slow steady increase throughout the follow-up period.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The hazard of mortality/transplant following discharge from definitive TOF repair shows an early peaking hazard that rapidly decreases during the first year and reaches a minimum at 4 years following discharge followed by an increasing late hazard period through 30 years following TOF repair.

    “Hazard function shows an early peaking hazard that rapidly decreases during the first year and reaches a minimum at 4 years following discharge followed by an increasing late hazard period through 30 years following TOF repair.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    Patients with repaired TOF have a biphasic hazard for mortality, an early steep hazard during the first 4 years after TOF repair, and a late hazard with a slow increase in mortality after 6 years and acceleration 20 years later.

    “Patients with repaired TOF have a biphasic hazard for mortality, an early steep hazard during the first 4 years after TOF repair, and a late hazard with a slow increase in mortality after 6 years and acceleration 20 years later.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    Staged repair and non-valve-sparing operation were both associated with increased early-phase hazard for death following repair, ultimately translating to worsened long-term survival.

    “Staged repair and non-valve-sparing operation were both associated with increased early-phase hazard for death following repair, ultimately translating to worsened long-term survival.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Non-valve-sparing operation exposes patients to a higher likelihood of subsequent reoperation and perioperative complications.

  • May combine two claims.

    Interpretationown data

    Survival in the PCCC cohort exceeds 94% at 25 years after TOF repair, which is comparable with single-center US and international registry studies reporting 30-year survival between 80% and 98%.

    “Survival in the PCCC cohort exceeds 94% at 25 years after TOF repair, which is comparable with single-center US and international registry studies reporting 30-year survival between 80% and 98%.[7][8][9]17”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [7][8][9]17

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Study design and conductreasoning

    The large number of participating centers in the PCCC allows us to leverage center variation in the TOF surgical strategy and compare the effectiveness of each strategy in a quasiexperimental design based on center and regional variation.

    “The large number of participating centers in the PCCC allows us to leverage center variation in the TOF surgical strategy and compare the effectiveness of each strategy in a quasiexperimental design based on center and regional variation.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationcitation

    It is possible that some of the deaths in the TOF population may have been misclassified.

    “Extrapolating to our study, it is possible that some of the deaths in the TOF population may have been misclassified.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductnone given

    The primary strengths of our study are the large number of patients and participating centers as well as the length of follow-up.

    “The primary strengths of our study are the large number of patients and participating centers as well as the length of follow-up.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    The data highlight the shortcomings of early repair, staged, and non-valve-sparing approaches in the early period following repair.

    “The data highlight the shortcomings of early repair, staged, and non-valve-sparing approaches in the early period following repair.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    There is limited information regarding the status of the RVOT following surgery.

    “In addition, there is limited information regarding the status of the RVOT following surgery.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductnone given

    Type of surgical RVOT reconstruction and valve approach were assigned by the respective PCCC surgical codes; manual review of operative notes was performed when ambiguity existed.

    “Type of surgical RVOT reconstruction and valve approach were assigned by the respective PCCC surgical codes; manual review of operative notes was performed when ambiguity existed.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    The Pediatric Cardiac Care Consortium (PCCC) is the oldest and one of the largest clinical registries for interventions for congenital heart disease in the United States.

    “The Pediatric Cardiac Care Consortium (PCCC) is the oldest and one of the largest clinical registries for interventions for congenital heart disease in the United States.[11][12][13]”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [11][12][13]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

26 of 26

  • The paper relies on this without support.

    Non-valve-sparing operation exposes patients to a higher likelihood of subsequent reoperation and perioperative complications.

    “Patients with non-valve-sparing approach are exposed to higher likelihood for subsequent reoperation and perioperative complications.”
1 of 1

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Studies based on multicenter surgical registries found increased survival and decreased reintervention rates among patients who underwent a VS procedure compared with those who underwent TAP.

    “The risk-benefit balance of VS procedures compared with TAP remains unclear in this setting even if studies3,16,17,18,19,20 based on multicenter surgical registries found increased survival and decreased reintervention rates among patients who underwent a VS procedure compared with those who underwent TAP.”

    From Comparison of Long-term Outcomes of Valve-Sparing and Transannular Patch Procedures for Correction of Tetralogy of Fallot (2021) · cites this paper as [3]

    The Factors Associated With Long-term Mortality section (page not provided) reports higher early mortality with non-valve-sparing than valve-sparing repair, supporting a survival advantage for valve-sparing procedures in this multicenter registry. The Patterns of Long-term Survival section says non-valve-sparing patients have a higher likelihood of subsequent reoperation, but the Strengths and Limitations section says the registry lacks data on the frequency of subsequent procedures. Thus, this paper does not establish decreased reintervention rates, and its measured survival comparison is not specifically valve-sparing versus TAP. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • Smith et al found that patients with TAP had a 3.5-fold increased risk of undergoing a PVR compared with patients who did not undergo TAP.

    “Smith et al3 found that patients with TAP had a 3.5-fold increased risk of undergoing a PVR compared with patients who did not undergo TAP.”

    From Comparison of Long-term Outcomes of Valve-Sparing and Transannular Patch Procedures for Correction of Tetralogy of Fallot (2021) · cites this paper as [3]

    In “Patterns of Long-term Survival After TOF Repair” (page unavailable), Smith et al. report that prior studies found fewer valve replacements after valve-sparing repair than after transannular patch repair. Our copy does not report a 3.5-fold risk of pulmonary valve replacement or present that comparison as a finding of Smith et al.’s own study. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • The 2019 Pediatric Cardiac Care Consortium study reported an overall survival of 94.5% and a 3.8-fold increased risk of mortality for the non-VS group.

    “The 2019 Pediatric Cardiac Care Consortium study3 reported an overall survival of 94.5% and a 3.8-fold increased risk of mortality for the non-VS group.”

    From Comparison of Long-term Outcomes of Valve-Sparing and Transannular Patch Procedures for Correction of Tetralogy of Fallot (2021) · cites this paper as [3]

    The Long-term Survival After Complete TOF Repair section reports 94.5% transplant-free survival at 25 years among patients discharged alive after repair—not an unqualified overall survival rate. Factors Associated With Long-term Mortality reports an adjusted hazard ratio of 3.76 for non-valve-sparing versus valve-sparing repair, but only in the early period, less than six years after repair. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Time of minimum hazard differs across descriptions

    Minor

    The Figure 1 caption places the minimum hazard at 4 years after discharge, while the results text places it at 6 years.

  • Survival advantage is assigned to the higher-risk approaches

    Minor

    The results sentence says staged and non-valve-sparing repair produce a long-term survival advantage over primary and valve-sparing repair. Elsewhere, the paper says those same approaches increase early mortality and worsen long-term survival.

  • Adjusted hazard-ratio confidence limit differs between text and table

    Minor

    The results text gives an upper 95% confidence limit of 9.91 for the adjusted non-valve-sparing hazard ratio, whereas both Table 2 and the abstract give 9.19.

3 of 3

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. Bilgrad, 1999, National Death Index Plus: Coded Causes of death: Supplement to the National Death Index user’s Manual

Cited by

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Authors
Smith, C. A., McCracken, C., Thomas, A. S., Spector, L. G., St Louis, J. D., Oster, M. E., Moller, J. H., & Kochilas, L.
Affiliations
  • Emory University (US)
  • University of Minnesota (US)
  • Department of Pediatric Surgery, University of Missouri, Kansas City School of Medicine
Corresponding author
Kochilas, Lazaros
ORCID
Venue
JAMA Cardiology
Publisher
American Medical Association (AMA)
Published
2019-01-01
Volume
4
Issue
1
Pages
34
ISSN
2380-6583 (ISSN-L)
DOI
10.1001/jamacardio.2018.4255
PMC
PMC6439686
OpenAlex
W2904473257
Cited by
176
References
28
Citations by year
2026: 22 · 2025: 28 · 2024: 29 · 2023: 26 · 2022: 26 · 2021: 24 · 2020: 13 · 2019: 6 · 2018: 1 · 2012: 1
FWCI
8.57
Type
journal article
Language
en
Open access
Locations
  • JAMA Cardiology (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Heart, Lung, and Blood Institute (R01HL122392)
Topics
  • Health Sciences › Medicine › Epidemiology › Congenital Heart Disease Studies
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Congenital heart defects research
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiovascular Conditions and Treatments
Keywords
tetralogy of Fallot, long-term survival, transplant-free survival, cyanotic congenital heart disease, surgical repair, staged repair, genetic abnormalities, mortality risk factors, pediatric cardiac surgery
MeSH terms
Adolescent, Cardiac Care Facilities, Cause of Death, Child, Child, Preschool, Female, Humans, Infant, Male, Pediatrics, Registries, Retrospective Studies, Risk Factors, Tetralogy of Fallot, United States, Cohort Studies, Survival Analysis, Treatment Outcome, Hospital Mortality, Young Adult

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Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-11.

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