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Is early primary repair for correction of tetralogy of Fallot comparable to surgery after 6 months of age?

Department of Cardiothoracic Surgery, Southampton General Hospital, Southampton, UK

*Corresponding author. Department of Paediatric Cardiac Surgery, Wessex Cardiothoracic Centre, Southampton University Hospitals NHS Trust, Southampton General Hospital, Tremona Road, Southampton, UK. Tel.: +44-2380 777222; fax: +44-2380798508.

E-mail address: marcus.haw{at}suht.nhs.uk (M.P. Haw).

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether early primary repair for correction of tetralogy of Fallot (TOF) resulted in better outcomes than surgery after 6 months of age. Altogether 650 relevant papers were identified using the below mentioned search, eight papers represented the best evidence to answer the specific question. The author, journal, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses were tabulated. We conclude that early primary repair of TOF has been shown to be comparable to later repair, with several retrospective series concluding that there is no increase in mortality with children under 6 months of age. Freedom from reintervention has also been shown to be similar irrespective of the age primary repair is undertaken. However, it has been observed that length of intensive care unit stay, period of mechanical ventilation and the need for inotropes is increased in patients undergoing primary repair at <3 months of age.

Key Words: Tetralogy of Fallot; Cardiac surgery; Infants; Evidence based medicine

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				T. Tirilomis eComment: Correction of tetralogy of Fallot Interactive CardioVascular and Thoracic Surgery, August 1, 2008; 7(4): 701 - 701. [Full Text] [PDF]