This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Theodor Tirilomis Permission Requests Google Scholar Articles by Tirilomis, T. PubMed Articles by Tirilomis, T. Related Collections Related Article

eComment: Correction of tetralogy of Fallot

Department for Thoracic, Cardiac, and Vascular Surgery, University of Göttingen, Göttingen 37075, Germany

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

I read with great interest the best evidence article by Vohra et al. [1] regarding optimal timing for repair of tetralogy of Fallot. The authors searched relevant papers to answer the question if early primary repair is comparable to surgery after 6 months of age.

Reading the title of the topic two questions arise; first, what is early repair and second, if we are talking about early repair what should the definition of late repair be? Should early repair be related to the time of diagnosis confirmation or to the age of the patient? In presented publications patient groups vary widely regarding age, from newborn age [2], 6 months [3], 12 months [4], to older patients [5]. Should late repair be performed after the first year of life or after 6 months or should indication for corrective surgery be body weight related?

Data of this best evidence topic [1] clearly demonstrate that repair of tetralogy of Fallot can be performed safely at any age, but mortality and especially morbidity are, even if low, increased in infants under three months of age. In accordance to these findings in symptomatic patients younger than three months we have to discuss every individual case carefully and sometimes even the alternative procedure of two-step repair should be taken into account.

	References

Top References

 

1. Vohra HA, Adamson L, Haw MP. Is early primary repair for correction of tetralogy of Fallot comparable to surgery after 6 months of age? Interact Cardiovasc Thorac Surg 2008;7:698–701.[Abstract/Free Full Text]
2. Kolcz J, Pizzaro C. Neonatal repair of tetralogy of Fallot results in improved pulmonary artery development without increased need for intervention. Eur J Cardiothorac Surg 2005;28:394–399.[Abstract/Free Full Text]
3. Lee C, Lee CN, Kim SC, Lim C, Chang YH, Kang CH, Jo WM, Kim WH. Outcome after one-stage repair of tetralogy of Fallot. J Cardiovasc Surg (Torino) 2006;47:65–70.[Medline]
4. Ooi A, Moorjani N, Baliulis G, Keeton BR, Salmon AP, Monro JL, Haw MP. Medium term outcome for infant repair in tetralogy of Fallot: indicators for timing of surgery. Eur J Cardiothorac Surg 2006;30:917–922.[Abstract/Free Full Text]
5. van Dongen EI, Glansdorp AG, Mildner RJ, McCrindle BW, Sakopoulos AG, van Arsdell G, Williams WG, Bohn D. The influence of perioperative factors on outcome in children aged less than 18 months after repair of tetralogy of Fallot. J Thorac Cardiovasc Surg 2003;126:703–710.[Abstract/Free Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Theodor Tirilomis Permission Requests Google Scholar Articles by Tirilomis, T. PubMed Articles by Tirilomis, T. Related Collections Related Article