What is the Optimal Age for Repair of Tetralogy of Fallot?
Abstract
Background Controversy regarding the timing for the repair of tetralogy of Fallot centers around initial palliation versus primary repair for the symptomatic neonate/young infant and the optimal age for repair of the asymptomatic child. We changed our approach from one of initial palliation in the infant to one of primary repair around the age of 6 months, or earlier if clinically indicated. We examined the effects of this change in protocol and age on outcomes. Methods and results The records of 227 consecutive children who had repair of isolated tetralogy of Fallot from January 1993 to June 1998 were reviewed. The median age of repair by year fell from 17 to 8 months (P: 12 months. The best survival and physiological outcomes were achieved with primary repair in children aged 3 to 11 months. Conclusions On the basis of mortality and physiological outcomes, the optimal age for elective repair of tetralogy of Fallot is 3 to 11 months of age.
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Older age at the time of surgery is a risk factor for postoperative mortality.
“Other studies have shown a similar trend and have identified older age at the time of surgery as a risk factor for postoperative mortality.6”
From Tetralogy of Fallot in Low- and Middle-Income Countries (2024) · cites this paper as [6]
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References 14 · Cited by 220
- Authors
- Van Arsdell, G. S., Maharaj, G. S., Tom, J., Rao, V. K., Coles, J. G., Freedom, R. M., Williams, W. G., & McCrindle, B. W.
- Venue
- Circulation
- Published
- 2000-11-07
- Volume
- 102
- Issue
- Supplement 3
- Pages
- III-123-III-129
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2137126315
- Cited by
- 220
- References
- 14
- Citations by year
- 2025: 5 · 2024: 7 · 2023: 11 · 2022: 11 · 2021: 10 · 2020: 14 · 2019: 8 · 2018: 13 · 2017: 11 · 2016: 7 · 2015: 4 · 2014: 12 · 2013: 16 · 2012: 13
- FWCI
- 3.47
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Circulation (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, primary repair, palliative shunt, timing of surgical repair, neonatal palliation, postoperative mortality, lactate clearance, length of hospital stay, physiological outcomes
- MeSH terms
- Age Factors, Blood Pressure, Canada, Child, Child, Preschool, Female, Cardiac Surgical Procedures, Humans, Infant, Infant, Newborn, Length of Stay, Male, Palliative Care, Reoperation, Tetralogy of Fallot, Cohort Studies, Survival Rate, Multivariate Analysis, Treatment Outcome, Age Distribution, Lactic Acid
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