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Early Primary Repair of Tetralogy of Fallot in Neonates and Infants Less Than Four Months of Age
Abstract
Background The ideal age for correction of tetralogy of Fallot is still under discussion. The aim of this study was to analyze morbidity and mortality in patients who underwent early primary repair of tetralogy of Fallot at the age of less than 4 months and to assess whether neonates, who needed early repair within the first 4 weeks of life, faced an increased risk. Methods From 1995 to 2006, 90 consecutive patients with tetralogy of Fallot and pulmonary stenosis underwent early primary repair. Patient charts were analyzed retrospectively for two groups: group A, 25 neonates younger than 28 days who needed early operation owing to duct-dependent pulmonary circulation or severe hypoxemia; and group B, 65 infants younger than 4 months of age who underwent elective early repair. Results There was no 30-day mortality; late mortality was 2% after a median follow-up time of 4.7 years. Seven of 88 patients (8%) needed reoperation and twelve of 88 patients (14%) needed reintervention. Groups A and B did not differ significantly in terms of intensive care unit stay, days of mechanical ventilation, overall hospital stay, major or minor complications, or reoperation. Significant differences were found in a more frequent use of a transannular patch (p = 0.045) and more reinterventions (p = 0.046) in group A. Conclusions Early primary repair of tetralogy of Fallot can be performed safely and effectively in infants younger than 4 months of age and even in neonates younger than 28 days with duct-dependent pulmonary circulation or severe hypoxemia.
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“Some investigators reported that the freedom from reintervention was decreased with the use of TAP.11,33”
From Comparison of Long-term Outcomes of Valve-Sparing and Transannular Patch Procedures for Correction of Tetralogy of Fallot (2021) · cites this paper as [33]
In the citing paper
“Many studies found no difference in survival comparing TAP and VS procedures,11,18,20,32,33,34,36,37,38,40”
From Comparison of Long-term Outcomes of Valve-Sparing and Transannular Patch Procedures for Correction of Tetralogy of Fallot (2021) · cites this paper as [34]
In the citing paper
“Many studies found no difference in survival comparing TAP and VS procedures,11,18,20,32,33,34,36,37,38,40”
From Comparison of Long-term Outcomes of Valve-Sparing and Transannular Patch Procedures for Correction of Tetralogy of Fallot (2021) · cites this paper as [33]
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Stewart, R. D., Mavroudis, C. D., & Backer, C. L. (2012) · Wiley eBooks · doi:10.1002/9781118320754.ch22 · Cited by 3
Vo, C., Bushman, G. A., Kleiman, Z. I., & Quiñónez, Z. A. (2023) · Springer eBooks · doi:10.1007/978-3-031-10442-8_22 · Cited by 2
Symptomatic Neonates With Tetralogy of Fallot: Shunt or Primary Repair?
Ye, X. T., Henmi, S., Buratto, E., Haverty, M. C., Yerebakan, C., Fricke, T. A., Brizard, C. P., d’Udekem, Y., & Konstantinov, I. E. (2025) · Heart Lung and Circulation · doi:10.1016/j.hlc.2025.01.009 · Cited by 2
Clemente, E. A., Casares, Á. P., Frontera, P. R., Calvar, J. M. C., & Sánchez-de-Toledo, J. (2021) · Pediatric Cardiology · doi:10.1007/s00246-021-02615-z · Cited by 2
Long-Term Outcomes of Patients with Tetralogy of Fallot Repaired in Young Infants and Toddlers
Chiu, S., Wang, J., Lin, M., Wu, E., Chen, C., Huang, S., Chang, C., Chen, Y., Chiu, I., & Wu, M. (2012) · Zhōnghuá mínguó xīnzàngxué huì zázhì · Cited by 2
Tetralogy of Fallot with Pulmonary Stenosis
Duncan, B. W. (2010) · Elsevier eBooks · doi:10.1016/b978-1-4160-5225-8.00119-7 · Cited by 2
Bushman, G. A. (2017) · Springer eBooks · doi:10.1007/978-3-319-44691-2_19 · Cited by 2
Primary Repair of Tetralogy of Fallot May Be Cheaper but for How Long? Is There a Universal Truth?
d’Udekem, Y. (2018) · World Journal for Pediatric and Congenital Heart Surgery · doi:10.1177/2150135118793085 · Cited by 2
Tetralogy of Fallot with Pulmonary Stenosis
Stellin, G., Vida, V. L., & Padalino, M. A. (2016) · Elsevier eBooks · doi:10.1016/b978-0-323-24126-7.00119-8 · Cited by 2
Late arrhythmia in patients with repaired tetralogy of Fallot: who is at risk?
Grigaliūnas, G., Gumbienė, L., Valevičienė, N., Matačiūnas, M., Tarutis, V., Marinskis, G., & Aidietis, A. (2015) · Seminars in Cardiovascular Medicine · doi:10.2478/semcard-2015-0001 · Cited by 1
Pulmonary Artery Stenosis in Tetralogy of Fallot
Gao, B. (2023) · Cardiology in Review · doi:10.1097/crd.0000000000000627 · Cited by 1
Busro, P. W., Satria, R., Safitri, S., Sudirman, A. R., Bachmid, M. R., Fardhani, D. G., Nursalim, S., Billy, M. J., & Prasetio, R. (2024) · Cardiology in the Young · doi:10.1017/s1047951124025575 · Cited by 1
Bashir, M. N., Elkasaby, M. H., Belal, M. M., Saad, L. M., Khalefa, B. B., Yassin, M. N. A., El‐Hameed, M. M. A., Almawas, S., & El-Gayar, R. M. (2025) · Pediatric Cardiology · doi:10.1007/s00246-025-03949-8 · Cited by 1
Tetralogy of Fallot — Does MR imaging have the answers?
Luijnenburg, S. E., Vliegen, H. W., Mulder, B. J. M., & Helbing, W. A. (2009) · Progress in Pediatric Cardiology · doi:10.1016/j.ppedcard.2009.10.004 · Cited by 1
Eidem, B. W. (2008) · Elsevier eBooks · doi:10.1016/b978-1-4160-3754-5.50031-7 · Cited by 1
Impaired Pulmonary Arterial Elasticity and Ventricular Function in Fetuses With Tetralogy of Fallot
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Editorial Comment: Very early repair of tetralogy of Fallot: we can, but should we?
Hazekamp, M. G. (2013) · European Journal of Cardio-Thoracic Surgery · doi:10.1093/ejcts/ezt185
d’Udekem, Y. (2013) · European Journal of Cardio-Thoracic Surgery · doi:10.1093/ejcts/ezs292
Connolly, G. M., Armstrong, C., Caputo, M., & Morgan, G. J. (2013) · BMJ Case Reports · doi:10.1136/bcr-2013-201085
Metadata
- Authors
- Tamesberger, M. I., Lechner, E., Mair, R., Hofer, A., Sames-Dolzer, E., & Tulzer, G.
- Venue
- The Annals of Thoracic Surgery
- Publisher
- Elsevier BV
- Published
- 2008-12
- Volume
- 86
- Issue
- 6
- Pages
- 1928-1935
- ISSN
- 0003-4975 (ISSN-L)
- OpenAlex
- W2051098343
- Cited by
- 124
- References
- 27
- Citations by year
- 2026: 1 · 2025: 6 · 2024: 4 · 2023: 8 · 2022: 7 · 2021: 13 · 2020: 6 · 2019: 11 · 2018: 10 · 2017: 7 · 2016: 5 · 2015: 5 · 2014: 6 · 2013: 15 · 2012: 6
- FWCI
- 3.48
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Annals of Thoracic Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Congenital Heart Disease Studies
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Cardiovascular Conditions and Treatments
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Congenital heart defects research
- Keywords
- tetralogy of Fallot, neonates, infants, pulmonary stenosis, duct-dependent pulmonary circulation, severe hypoxemia, transannular patch, reintervention, reoperation, postoperative morbidity and mortality, timing of surgical repair
- MeSH terms
- Age Factors, Cause of Death, Female, Follow-Up Studies, Cardiac Surgical Procedures, Humans, Infant, Infant, Newborn, Male, Postoperative Complications, Probability, Pulmonary Valve Stenosis, Retrospective Studies, Sensitivity and Specificity, Tetralogy of Fallot, Time Factors, Echocardiography, Doppler, Cohort Studies, Survival Rate, Treatment Outcome, Hospital Mortality, Risk Assessment, Statistics, Nonparametric, Kaplan-Meier Estimate
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