Single-center 50 years’ experience with surgical management of tetralogy of Fallot☆
Open accessAbstract
OBJECTIVE: The aim of this study was to evaluate the long-term outcome of total repair for tetralogy of Fallot. We aimed to characterize late survival and the time-related risk of late reoperation. METHODS: Operative protocols, patient records, and the database of the department were evaluated from 1951 until 2008. The official death registry of Norway was used for follow-up. Of the patients identified, the follow-up was 99.6% complete. RESULTS: A total of 627 patients were studied. Of these, 570 could be identified for follow-up. There were a total of 41 early and 30 late deaths. The total early (including palliative procedures) mortality was 7.2% and total late mortality was 7.9%. However, during the last 10 years, no early mortality has been observed following repair. A total of 264 patients underwent some form of palliative procedure as their first treatment, and 541 patients had a reparative procedure performed, with an early mortality of 31 (5.7%). In patients subjected to a reparative procedure, there was no difference in freedom from death or reoperation following primary repair versus primary palliation. The use of transannular patch was associated with a highly significant risk of reoperation. CONCLUSIONS: Surgical treatment of the tetralogy of Fallot and related congenital cardiac malformations has good long-term prognosis. In this cohort of patients, more than one-third required additional procedures later on, and, in some cases, as many as four additional surgeries. Palliative procedures followed by repair do not influence survival or reoperation-free survival. There are no differences between transatrial versus transventricular repair on survival or re-repair. Any transannular incision increases the risk of re-repair, but does not influence long-time survival. There is an almost linear decrease in reoperation-free survival following any type of repair of tetralogy of Fallot, even for as long as 50 years since the first procedure.
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Most previous single center studies did not find a difference in the risk of reintervention comparing surgical procedures for correction of TOF.
“Most previous single center studies did not find a difference in the risk of reintervention comparing surgical procedures for correction of TOF.18,20,32,38,40”
From Comparison of Long-term Outcomes of Valve-Sparing and Transannular Patch Procedures for Correction of Tetralogy of Fallot (2021) · cites this paper as [32]
The Results report no difference in freedom from reoperation between primary repair and repair after palliation, and the Abstract reports no difference in re-repair between transatrial and transventricular repair. But the Results also find a highly significant difference with transannular involvement, so this study does not support a general claim of no difference across surgical procedures. (LLM, conf=0.88)
Experimental — accuracy not yet measuredMany studies found no difference in survival comparing TAP and VS procedures.
“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 [32]
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References 13 · Cited by 77
Research works printed but not linked: 5
- Kirklin JW, Blackstone EH, Kirklin JK, Pacifico AD, Armamendi J, Bargeron Jr LM. Surgical results and protocols in the surgical spectrum of Tetralogy of Fallot. Ann Surg 1983;198:251-65.
- Michielon G, Marino B, Formigari R, Gargiulo G, Picchio F, Digilio MC, Anaclerio S, Oricchio G, Sanders SP, Di Donato RM. Genetic syndromes and outcome after surgical correction of Tetralogy of Fallot. Ann Thorac Surg 2006;8:968-75.
- Hennein HA, Mosca RS, Urcelay G, Crowley DC, Bove EL. Intermediate results after complete repair of tetralogy of Fallot in neonates. J Thorac Cardiovasc Surg 1995;109:332-42.
- Di Donato R, Jonas RA, lang P, Rome JJ, Mayer Jr JE, Castaneda AR. Neonatal repair of tetralogy of Fallot with and without pulmonary atresia. J Thorac Cardiovasc Surg 1991;101:126-37.
- Sousa UM, Lacour-Gayet F, Komiya T, Serraf A, Bruniaux J, Touchot A, Roux D, Petit J, Planche ´C. Surgery for Tetralogy of Fallot at less than six months of age. J Thorac Cardiovasc Surg 1994;107:1291-300.
- Authors
- Lindberg, H. L., Saatvedt, K., Seem, E., Hoel, T., & Birkeland, S.
- Affiliations
- Oslo University Hospital (NO)
- Corresponding author
- Saatvedt, Kjell
- Venue
- European Journal of Cardio-Thoracic Surgery
- Publisher
- Oxford University Press (OUP)
- Published
- 2011-02-26
- Volume
- 40
- Issue
- 3
- Pages
- 538-42
- ISSN
- 1010-7940 (ISSN-L)
- OpenAlex
- W2118357029
- Cited by
- 77
- References
- 13
- Citations by year
- 2025: 4 · 2024: 2 · 2023: 6 · 2022: 6 · 2021: 5 · 2020: 2 · 2019: 8 · 2018: 2 · 2017: 8 · 2016: 6 · 2015: 1 · 2014: 6 · 2013: 12 · 2012: 9
- FWCI
- 6.47
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Journal of Cardio-Thoracic Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Congenital Heart Disease Studies
- Health Sciences › Medicine › Surgery › Cardiac Structural Anomalies and Repair
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Congenital heart defects research
- Keywords
- tetralogy of Fallot, palliative procedures, transannular patch, reoperation, long-term survival, mortality, congenital heart disease, follow-up outcomes
- MeSH terms
- Age Factors, Child, Preschool, Follow-Up Studies, Heart Defects, Congenital, Humans, Infant, Norway, Palliative Care, Prognosis, Reoperation, Tetralogy of Fallot, Survival Analysis, Treatment Outcome, Prostheses and Implants
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