Impact of timing on in-patient outcomes of complete repair of tetralogy of Fallot in infancy: an analysis of the United States National Inpatient 2005–2011 database

Yang, Shihai; Wen, Linlin; Tao, Shuguang; Gu, Jin; Han, Jiangang; Yao, Junping; Wang, Jianming

doi:10.1186/s12872-019-0999-1

Cited by 21 publications

(14 citation statements)

References 19 publications

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“…In our study, 125 children had complete repair of TOF at a median age of 4.4 years (IQR 3-5.7), with no mortality at 30 days after surgery. These are excellent results compared with the studies mentioned above and comparable to those of early complete repair of TOF [16].…”

Section: Discussionsupporting

confidence: 78%

“…All of the other similar studies on late complete repair of TOF in children reported shorter lengths of stay, with ICU LOS ranging from a mean of 1.8 ± 1.2 days to 5 ± 3 days and hospital LOS ranging from a mean of 7.6 ± 3.8 days to 15 ± 7 days [8,9,13,15]. Outcome studies on complete repair of TOF in infancy show either comparable or shorter ICU and hospital LOS compared with our study [16,17,21,22]. We found no patient-related factors that could explain the higher ICU and hospital LOS in our study.…”

Section: Discussionsupporting

confidence: 70%

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Contemporary early results of late repair of tetralogy of Fallot in children: a single-centre case series

Mottier

Prša

2021

Swiss Med Wkly

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AIMS: To describe the early results of complete repair of tetralogy of Fallot (TOF) in children older than one year of age.METHODS: We identified all patients older than one year of age who underwent TOF repair between 2007 and 2017. Data collected included type of surgical repair, survival at 30 days after surgery, reintervention within 30 days of surgery, length of stay in the intensive care unit (ICU), length of stay in hospital, and degree of residual right ventricular outflow tract (RVOT) stenosis and pulmonary insufficiency 30 days after surgery. RESULTS: 125 children (median age 4.4 years, interquartile range [IQR] 3-5.7) underwent complete repair of TOF, with pulmonary valve preservation in 66%, a transannular patch in 19%, and a valved right ventricular-to-pulmonary artery conduit in 15%. All patients survived. There were twelve (9.6%) reinterventions. Median ICU length of stay was 7 days and median hospital length of stay was 12 days. Significant residual RVOT stenosis was present in 7.2% and significant pulmonary insufficiency in 19.2%. Patients with a transannular patch had a significantly higher proportion of significant residual RVOT stenosis and significant pulmonary insufficiency compared with the other types of surgical repair. CONCLUSIONS: Compared with the existing literature on complete late repair of TOF in children, this study showed good early results with no mortality, similar rates of reintervention and valve-preserving surgery, higher ICU and hospital length of stay, higher incidence of significant residual RVOT stenosis, and lower incidence of significant pulmonary insufficiency. Repair with a transannular patch was a risk factor for significant residual RVOT stenosis and significant pulmonary insufficiency.

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Section: Discussionsupporting

confidence: 78%

Section: Discussionsupporting

confidence: 70%

Contemporary early results of late repair of tetralogy of Fallot in children: a single-centre case series

Mottier

Prša

2021

Swiss Med Wkly

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“…Most infants have surgical repair at 3-6 months of age [2]. An multivariate analysis showed that the risk of post-operative complications was 40% lower in infants ≥ 91 days old compared to those ≤30 days old [7].…”

Section: Discussionmentioning

confidence: 99%

Brain Abscess Due to Neglected Tetralogy of Fallot: A Case Report

Malisie

Abdillah

Saputra³

et al. 2021

Open Access Maced J Med Sci

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Backgroiund: Tetralogy of Fallot (TOF) is a type of congenital heart disease accounts for about 10% of all congenital cardiac deformities, and is the most common cyanotic lesion after the first year of life. The ideal age for correction of tetralogy of Fallot is still under discussion. Non-cardiac manifestation due to oxygen deficiency has to be aware of in cyanotic patient is brain abscess, because of the right-left shunt in long standing TOF. Objectives: To report a case of neglected TOF. Case And Discussion: A one-year-old male presented to Murni Teguh Memorial Hospital with the chief complaint of stiffed neck for the past 3 days and got fever for 10 days before admitted, with nausea and vomiting. He was diagnosed with Tetralogy of Fallot through an echocardiography examination when he was 2 months old, but never go through any medical nor surgical treatment. The boy responded to verbal, no eye contact, high grade fever, stiffed neck, Kernig sign and Brudzinski sign was found, and the right extremities were spastic, clubbing finger. On cardiac examination, there was systolic murmur grade ¾ in the left second intercostal space. Echocardiography evaluation revealed dilated RA-RV, no PDA shunt, large mal alignment ventricular septal defect, overriding aorta > 50%, right ventricular hypertrophy, and severe infundibular pulmonary stenosis, consistent with Tetralogy of Fallot. During hospitalization, there were several episodes of seizure and decreased of consciousness, brain CT investigation was done. The abscess was evacuated and a ventriculoperitoneal shunt was performed. One week after the operation, the patient developed abdominal distention, green bile like vomiting, decreased bowel movement and soon muscular defense. From the plain abdominal x-ray and CT revealed peritonitis and intestinal obstruction. An emergency laparotomy was performed, followed by adhesiolysis and jejunostomy due to jejunal perforation. The boy passed away after several episodes of septic shock. Conclusions: We would like to emphasis the consequence of the neglected treatment in infant with TOF.

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“…Surgical intervention is usually performed in the first year of life, with the majority of repairs performed electively before age six months. If the RVOT obstruction is not critical, intracardiac repair is typically deferred until after the neonatal period not only to allow pulmonary vascular resistance to drop but also to give time to the infant to gain weight [23]. Neonatal surgical intervention may be needed in the setting of severe RVOT obstruction with or without ductal dependency [24].…”

Section: Discussionmentioning

confidence: 99%

Surgical Outcomes in Syndromic Tetralogy of Fallot: A Systematic Review and Evidence Quality Assessment

et al. 2019

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Background: Tetralogy of Fallot (ToF) is one of the most common cyanotic congenital heart defects. We sought to summarize all available data regarding the epidemiology and perioperative outcomes of syndromic ToF patients. Methods: A PRISMA-compliant systematic literature review of PubMed and Cochrane Library was performed. Results: Twelve original studies were included. The incidence of syndromic ToF was 15.3% (n=549/3,597). The most prevalent genetic syndromes were 22q.11.2 deletion (47.8%; 95% CI: 43.4-52.2) and trisomy 21 (41.9%; 95% CI: 37.7-46-3). Complete surgical repair was performed in 75.2% of the patients (n=161/214; 95% CI: 69.0-80.1) and staged repair in 24.8% (n=53/214; 95 CI: 19.4-30.9). Relief of RVOT obstruction was performed with transannular patch in 64.7% (n=79/122; 95% CI: 55.9-72.7) of the patients, pulmonary valve-sparing technique in 17.2% (n=21/122; 95% CI: 11.5-24.9), and RV-PA conduit in 18.0% (n=22/122; 95% CI: 12.1-25.9). Pleural effusions were the most common postoperative complications (n=28/549; 5.1%; 95% CI: 3.5-7.3). Reoperations were performed in 4.4% (n=24/549; 95% CI: 2.9-6.4) of the patients. All-cause mortality rate was 9.8% (n=51/521; 95% CI: 7.5-12.7). Conclusion: Genetic syndromes are seen in approximately 15% of ToF patients. Long-term survival exceeds 90%, suggesting that surgical management should be dictated by anatomy regardless of genetics.

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Impact of timing on in-patient outcomes of complete repair of tetralogy of Fallot in infancy: an analysis of the United States National Inpatient 2005–2011 database

Cited by 21 publications

References 19 publications

Contemporary early results of late repair of tetralogy of Fallot in children: a single-centre case series

Contemporary early results of late repair of tetralogy of Fallot in children: a single-centre case series

Brain Abscess Due to Neglected Tetralogy of Fallot: A Case Report

Surgical Outcomes in Syndromic Tetralogy of Fallot: A Systematic Review and Evidence Quality Assessment

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