Optimal Timing for Elective Early Primary Repair of Tetralogy of Fallot: Analysis of Intermediate Term Outcomes

Cunningham, Michael E.; Donofrio, Mary T.; Peer, Syed Murfad; Zurakowski, David; Jonas, Richard A.; Sinha, Pranava

doi:10.1016/j.athoracsur.2016.07.020

Cited by 31 publications

(14 citation statements)

References 17 publications

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“…Controversy exists between authors who suggest that a total complete repair should be performed during the first 4 to 6 weeks of age, regardless of clinical presentation and anatomic findings [4,17]; however, some other authors promote the use of systemic-to-pulmonary shunts or a right ventricular outflow tract stent in very symptomatic neonates before the total repair, showing similar outcomes to total repair strategies [5,18].…”

Section: Commentmentioning

confidence: 99%

Tetralogy of Fallot Repair in Developing Countries: International Quality Improvement Collaborative

Sandoval

Carreño

Novick

et al. 2018

The Annals of Thoracic Surgery

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Section: Commentmentioning

confidence: 99%

Tetralogy of Fallot Repair in Developing Countries: International Quality Improvement Collaborative

Sandoval

Carreño

Novick

et al. 2018

The Annals of Thoracic Surgery

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“…Cunningham et al showed that surgeries in tetralogy of Fallot patients older than 55 days were safe. 16 A study in Pakistan by Memon et al showed that mean age 9.39 ± 2.3 months had good outcomes after tetralogy of Fallot repair. 17 Baseline saturation <75% was an independent risk factor for low cardiac output syndrome and prolonged intubation.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for severe pulmonary regurgitation after repair of tetralogy of Fallot with transannular patch

et al. 2020

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Background: Severe pulmonary regurgitation may result in right ventricular volume overload and decreased right ventricular function. Severe pulmonary regurgitation can be predicted prior to repair of tetralogy of Fallot. The aim of this study was to determine the risk factors for severe pulmonary regurgitation in repaired tetralogy of Fallot with transannular patch. Methods: This was a cross-sectional study in 43 patients with repaired tetralogy of Fallot using transannular patch. This study was carried out in Dr. Cipto Mangunkusumo hospital during 2015 to 2018. Participants were followed up for routine examination using echocardiography. We used bivariate and multivariate logistic regression using STATA 12.1 to identify risk factors for severe pulmonary regurgitation in this population. Results: A total of 43 patients composed of 22 boys and 21 girls with repaired tetralogy of Fallot using transannular patch were enrolled in the study. Median age of participants was 6 years at admission (2.1–18.5 years) and 3.4 years (1–17 years) at repair. Median length of follow-up was 2.1(1–4.3) years. Risk factors associated with severe pulmonary regurgitation after tetralogy of Fallot repair were McGoon ratio > 1.8 (odds ratio = 6.9; 95% confidence interval = 1.6–30) and follow-up duration >1.9 years (odds ratio = 3.6; 95% confidence interval = 0.9–15.2). Conclusion: McGoon ratio > 1.8 and follow-up duration > 1.9 years are associated with severe pulmonary regurgitation after tetralogy of Fallot repair.

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“…If oxygen saturations are adequate, infants are discharged home on medications such as propranolol (to improve arterial oxygen saturations), which allows time for the pulmonary arteries to grow prior to surgery (Hoffman, ). Surgical intervention patching the VSD and enlarging the pulmonary valve is done between 2 and 6 months of age (Cunningham et al, ).…”

Section: Congenital Heart Diseasementioning

confidence: 99%

Improving neurodevelopment in infants with complex congenital heart disease

Harrison

2019

Birth Defects Research

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Worldwide, more than 400,000 infants are born each year with complex congenital heart disease (CCHD) requiring surgical intervention within the first months of life. Although improvements in perioperative care have resulted in increased rates of survival, more than half of infants with CCHD have neurodevelopmental impairments affecting subsequent educational achievements, job opportunities, and mental health. Brain maturity and impaired outcomes in infants with CCHD are similar to those of prematurely born infants. Developmentally supportive care, including foundational application of kangaroo care (KC), improves neurodevelopment in premature infants. Provision of developmentally supportive care with KC during the early hospitalization of infants with CCHD has the potential to similarly improve neurodevelopment. The purposes of the article are to describe common congenital heart defects, describe developmentally supportive care with an emphasis on KC, and to offer specific recommendations for KC and research in infants with CCHD.

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Optimal Timing for Elective Early Primary Repair of Tetralogy of Fallot: Analysis of Intermediate Term Outcomes

Abstract: Elective repair in patients greater than 55 days of age, irrespective of size of the patient, can be safely performed without any increase in reintervention rates. Both residual peak RVOT gradient and TPS are effective in identifying patients at increased risk of reintervention.

Cited by 31 publications

References 17 publications

Tetralogy of Fallot Repair in Developing Countries: International Quality Improvement Collaborative

Tetralogy of Fallot Repair in Developing Countries: International Quality Improvement Collaborative

Risk factors for severe pulmonary regurgitation after repair of tetralogy of Fallot with transannular patch

Improving neurodevelopment in infants with complex congenital heart disease

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