Primary early correction of tetralogy of Fallot irrespective of age

Abstract

Elective primary repair of tetralogy of Fallot in asymptomatic patients is delayed beyond 3 months of age. In symptomatic patients, primary repair of tetralogy of Fallot is performed irrespective of age, weight and preoperative state. This approach is safe, and provides an excellent midterm outcome with acceptable morbidity and rates of reintervention. The long-term benefits of this approach must be established by careful follow-up, with particular emphasis on arrhythmias, right ventricular function, and exercise performance.

An audit of surgical repair of Tetralogy of Fallot in an African tertiary care centre

“…(4,13,9) However, similar results in primary repair of TOF in the neonatal period have not been achieved at the same level as other centers with better resources and infrastructure.…”

Midgestation Fetal Pulmonary Annulus Size Is Predictive of Outcome in Tetralogy of Fallot

“…Tetralogy of Fallot (TOF) is the most common form of cyanotic congenital heart disease, occurring in ∼3 of every 10 000 newborns and accounting for 7–10% of congenital heart disease . Outcomes after TOF repair are excellent, with surgical mortality <2% and 15‐year survival rates >95% . Despite excellent outcomes over the first several decades of life, the late deleterious effects of pulmonary regurgitation and subsequent right ventricular volume overload have been well established .…”

“…1 Outcomes after TOF repair are excellent, with surgical mortality <2% and 15-year survival rates >95%. [1][2][3] Despite excellent outcomes over the first several decades of life, the late deleterious effects of pulmonary regurgitation and subsequent right ventricular volume overload have been well established. [4][5][6][7] Because of known sequelae of right ventricular volume overload and dilation, including heart failure, arrhythmia, and sudden death, [4][5][6][7][8] surgical management of TOF has increasingly moved toward pulmonary valve-sparing approaches rather than transannular patch (TAP) repair.…”

Results of elective repair at 6 months or younger in 277 patients with tetralogy of Fallot: A 14-year experience at a single center

“…Surgical intervention for tetralogy of Fallot (TOF) during infancy has become routine in many centers since the first successful ''correction'' by Lillehei et al 1 more than 50 years ago, 2,3 and acceptable outcomes into young adulthood have been described. [4][5][6][7][8] Most centers in the world have, by consensus, planned elective repair early in life in patients with TOF, however, the optimal timing of elective surgical intervention continues to be controversial. 6,[9][10][11][12][13] The literature includes reports of theoretical long-term advantages of primary repair at younger ages, 4,6,9,14 and experience with repair in early infancy.…”