Complete repair of tetralogy of Fallot in infancy

Area of Science:

• Pediatric Cardiac Surgery
• Congenital Heart Disease
• Cardiovascular Surgery

Background:

• Tetralogy of Fallot (TOF) is a complex congenital heart defect requiring surgical intervention.
• Complete repair in infancy aims to correct the defect and improve long-term outcomes.
• Evaluating long-term results of early surgical correction is crucial for optimizing patient care.

Purpose of the Study:

• To assess the long-term outcomes of complete surgical repair of Tetralogy of Fallot (TOF) in infants.
• To evaluate mortality, morbidity, reoperation rates, and functional status after early TOF repair.
• To determine the impact of surgical technique on postoperative right ventricular function.

Main Methods:

• Retrospective review of 160 infants undergoing complete TOF repair between January 1990 and April 2002.
• Surgical correction involved a short right ventriculotomy and, in some cases, a transannular patch.
• Long-term follow-up included clinical assessment (NYHA functional class) and echocardiography.

Main Results:

• Mean age at repair was 8.1 months; 49% received a transannular patch.
• There were 4 early deaths and no late deaths, with complete follow-up.
• 1- and 10-year actuarial freedom from reoperation was 94.0% and 87.5%, respectively.
• All survivors are in NYHA functional class I or II, with excellent right ventricular function on echocardiography.

Conclusions:

• Early complete repair of TOF in infants yields acceptable results with low mortality and morbidity.
• The transventricular repair approach can be safely applied, preserving good postoperative right ventricular function.
• Infants with TOF benefit from early surgical correction, achieving favorable long-term functional status and cardiac performance.