Tetralogy of Fallot in the Current Era

• DOI: 10.1053/j.semtcvs.2018.10.015
• Publication Date: 2018-11-02T14:26:09Z
• Authors: Elisabeth M.J.P. ...; Natasja M.S. de G...; Pieter C. van de ...; Peter L. de Jong; Wim A. Helbing; Ingrid M. van Beynum; Ad J.J.C. Bogers
• Keywords: Interquartile range; Pulmonary valve

Only few studies have reported long-term outcome of the transatrial-transpulmonary approach in current era management tetralogy Fallot (ToF). We investigated 15-year correction via a large cohort successive patients operated 21st century. All infant ToF undergoing between 2000 and 2015 were included (N = 177, 106 male, median follow-up 7.1 (interquartile range 3.0-10.9) years. Data regarding postoperative complications, reinterventions, development atrial ventricular arrhythmia, cardiac function, survival evaluated. Prior shunting was performed 10 (6%). The resulted valve-sparing surgery 57 (32%). Postoperative surgical complications junctional ectopic tachycardia 12, 7%), pericardial 10, 6%) or pleural effusion 7, 3%), chylothorax 4%), bleeding requiring reoperation 4, superficial wound infection 1). Fifty-one underwent 68 mainly due to pulmonary restenosis (PS) 57). at age <2 months double outlet double-chambered right ventricle variants spectrum independent predictors for reintervention. Patients had significant longer PR-free than those with transannular patch (8.5 [95% confidence interval 6.8-10.3] years vs 1.1 0.8-1.5] years; P < 0.001). Overall mortality 2.8%; rates higher premature/dysmature newborns (0.7% 9.5%; Although terms is excellent, high incidence moderate severe PR worrisome. Valve-sparing associated substantially lower PR, yet surgically not possible majority patients.