Tetralogy of Fallot: Influence of Surgical Technique on Survival and Reoperation Rate∗
Abstract
Background The influence of different surgical techniques in patients with Tetralogy of Fallot (TOF) on long-term survival and reoperation rate is still a matter of controversy. Patients and methods The data of 266 patients (152 male, 114 female, mean body weight: 13.4 +/- 11.9 kg, mean age 4.1 +/- 6.0 years) with TOF, including 30 patients (11.2 %) with TOF/pulmonary atresia, were analyzed retrospectively. A palliative surgical procedure preceded definite correction between 1975 and 1999 in 46 patients (17.5 %). The surgical technique consisted of a transannular patch in 103 patients (40.1 %); in 133 patients (51.8 %), a non-transvalvular technique was used. In 33 patients (12.3 %), a conduit was implanted into the right ventricular outflow tract (RVOT). For surgical access to the cardiac defects, a transventricular approach was used in 138 patients, and a transatrial/trans-pulmonary approach in 26 patients. The mean follow-up time of all patients was 6.6 years. Results Kaplan-Meier survival for the entire group was 86.2 % at one year and remained stable at 85.6 % after 5 years. The 30-day mortality was 10.1 % (27 patients). Fatal risk factors were: previous cardiac surgery, preoperative oxygen saturation (SO(2)) Conclusions In our series of TOF patients operated over a period of 25 years, we were unable to assess an influence of the surgical technique used for definite correction on mortality or reoperation rate. Pulmonary atresia in patients with TOF is associated with a h…
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Many 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 [40]
We did not have consistent information on the surgical approach (ie, transatrial or transpulmonary vs transventricular), which have been shown to be associated with short-term outcomes.
“We did not have consistent information on the surgical approach (ie, transatrial or transpulmonary vs transventricular), which have been shown to be associated with short-term outcomes.39”
From Comparison of Long-term Outcomes of Valve-Sparing and Transannular Patch Procedures for Correction of Tetralogy of Fallot (2021) · cites this paper as [39]
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 [40]
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Blais, S., Marelli, A., Vanasse, A., Dahdah, N., Dancea, A., Drolet, C., & Dallaire, F. (2021) · JAMA Network Open · doi:10.1001/jamanetworkopen.2021.18141 · Cited by 61 · see citing works
- Authors
- Boening, A., Scheewe, J., Paulsen, J., Regensburger, D., Kramer, H.-H., Hedderich, J., & Cremer, J. T.
- Affiliations
- University Hospital Schleswig-Holstein (DE)
- Venue
- The Thoracic and Cardiovascular Surgeon
- Publisher
- Georg Thieme Verlag KG
- Published
- 2001-12
- Volume
- 49
- Issue
- 6
- Pages
- 355-360
- ISSN
- 0171-6425 (ISSN-L)
- 1439-1902
- OpenAlex
- W1983745382
- Cited by
- 13
- References
- 0
- Citations by year
- 2024: 1 · 2023: 2 · 2021: 2 · 2019: 3 · 2012: 2
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Thoracic and Cardiovascular Surgeon (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Congenital Heart Disease Studies
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiovascular Conditions and Treatments
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Congenital heart defects research
- Keywords
- tetralogy of Fallot, surgical technique, long-term survival, reoperation rate, transannular patch, transventricular approach, transatrial approach, pulmonary atresia, palliative surgery, 30-day mortality, pediatric cardiac surgery, aortic cross-clamp time
- MeSH terms
- Adolescent, Child, Child Welfare, Child, Preschool, Female, Follow-Up Studies, Germany, Heart Failure, Cardiac Surgical Procedures, Humans, Infant, Infant Welfare, Infant, Newborn, Intraoperative Complications, Male, Postoperative Complications, Reoperation, Tetralogy of Fallot, Time, Time Factors, Ventricular Outflow Obstruction, Incidence, Survival Analysis, Treatment Outcome
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