Thorac Cardiovasc Surg 2004; 52
DOI: 10.1055/s-2004-816737

Primary early correction of tetralogy of fallot irrespective of age – Midterm outcome

V Becker 1, P Valentik 1, A Kantorova 2, K Ntalakoura 1, Ch Haun 1, J Weil 1, V Hraska 1, 2
  • 1University Hospital Hamburg-Eppendorf, Department of Pediatric Cardiac Surgery, Germany
  • 2Children's University Hospital Bratislava, Department of Pediatric Cardiac Surgery, Slovakia

Objectives: Performing an early total repair of tetralogy of Fallot (TOF) irrespective of age or placing a palliative systemic-to-pulmonary shunt remains controversial. The aim of the study was to analyze the mid-term outcome of primary early correction of TOF.

Material and Methods: Between 1996 and August 2003, a total of 55 patients less than 6 months of age, underwent primary correction of TOF in two institutions involved in the study. The median age at surgery was 3.3 months, 25 pts (45%) were <3 months of age including 11 (20%) newborns. The median weight was 4.2kg (from 2.3 to 10). Two groups were analyzed: I. pts <3 months; II. pts between 3–6 months of age.

Results: There was one early (1.8%) and one late death. Actuarial survival was 98% at 1 year and 95% at 5 years with a mean follow up of 2.5 years. There was no difference in survival, bypass time, lengths of ventilation and hospital stay between the two groups. The transanular patch used was significantly more common in group I. The freedom from re-do (including re-interventions) was 92% at 1 year and 88% at 5 years of FU with no difference between the two groups. There were no clinically apparent neurological problems during the FU. Patients are doing well and growth is adequate.

Conclusions: Primary repair of TOF, irrespective of age, provides excellent short and mid-term outcome with a low mortality and acceptable morbidity. Primary early correction of TOF is the method of choice in our institution.