Thorac Cardiovasc Surg 2001; 49(4): 210-215
DOI: 10.1055/s-2001-16109
Original Cardiovascular
© Georg Thieme Verlag Stuttgart · New York

Correction of Tetralogy of Fallot: Does the Time Period of Surgery Influence the Outcome?[]

A. Boening, J. Scheewe, D. Regensburger, S. Fraund, J. Paulsen, H.-H. Kramer, J. Cremer
  • Department of Cardiovascular Surgery and Department of Paediatric Cardiology, University Hospital, Kiel, Germany
Further Information

Publication History

Publication Date:
31 December 2001 (online)

Background: The perioperative outcome of patients with tetralogy of Fallot (TOF) seems to have improved over the last four decades. Methods: To prove this hypothesis, we retrospectively analysed the data of 269 TOF patients operated on between 1975 and 1999 in our institution. Results: Over the years, younger patients (median age 1975 - 1980: 4.5 years, 1995 - 1999: 0.9 years) were operated on with a lower mortality (1975 - 1980: 8.6 %, 1995 - 1999: 2.4 %). Residual defects such as pulmonary stenosis or insufficiency and VSD occurred with a similar frequency over time, whereas rhythm disturbances were significantly reduced (1981 - 1985: 51.2 %, 1995 - 1999: 24.4 %, p = 0.012). Postoperative length of hospital stay was significantly (p < 0.05) shorter in the years 1995 - 1999 (11.0 - 11.4 days) than in 1975 - 1980 (16.9 ± 16.5 days). Conclusions: Over time periods, there was a trend towards lower mortality and towards operating on patients in a younger age. The rate of rhythm disturbances and the LOS after surgery proved to be reduced during the last decade. These differences did not turn out to be statistically significant. Therefore, we conclude that the time period of surgery has only little impact on the early outcome of patients after definitive correction of TOF.

1 Results were presented at the 3rd Joint Meeting of the German, Austrian and Swiss Associations of Thoracic, Cardiac and Vascular Surgery in Lucerne, Switzerland, February 9 - 12, 2000

References

  • 1 Bertranou E G, Blackstone E H, Hazelrig J B, Turner M E, Kirklin J W. Life expectancy without surgery in tetralogy of Fallot.  Am J Cardiol. 1978;  42 458-466
  • 2 Lukacs L, Kassai I, Arvay A. Total correction of tetralogy of Fallot in adolescents and adults.  Thorac Cardiovasc Surg. 1992;  42 261-265
  • 3 Nollert G, Fischlein T, Bouterwek S, Böhmer C, Klinner W, Reichart B. Long-term survival in patients with repair of tetralogy of fallot: 37-year follow-up of 490 survivors of the first year after surgical repair.  J Am Coll Cardiol. 1997;  30 1374-1383
  • 4 Karl T R, Sano S, Pornviliwan S, Mee R BB. Tetralogy of Fallot: Favorable outcome of nonneonatal transatrial, transpulmonary repair.  Ann Thorac Surg. 1992;  54 903-907
  • 5 Walsh E P, Rockenmacher S, Keane J F, Hougen T J, Lock J E, Castaneda A R. Late results in patients with tetralogy of Fallot repaired during infancy.  Circulation. 1988;  77 1062-1067
  • 6 Caspi J, Zalstein E, Zucker N, Applebaum A, Harrison L H, Munfakh N A, Heck H A, Ferguson T B, Stopa A, White M, Fontenot E E. Surgical management of TOF in the first year of life.  Ann Thorac Surg. 1999;  68 1344-1349
  • 7 Zhao H -X, Miller D C, Reitz B A, Shumway N E. Surgical repair of tetralogy of Fallot: Long term follow-up with particular emphasis on late death and reoperation.  J Thorac Cardiovasc Surg. 1985;  89 204-220
  • 8 Stellin G, Milanesi O, Rubino M, Michielon G, Bianco R, Moreolo G S, Boneva R, Sorbara C, Casarotto D. Repair of TOF in the first six months of life: transatrial versus transventricular approach.  Ann Thorac Surg. 1995;  60 S 588-591
  • 9 Calza G, Panizzon G, Rovida S, Aigueperse J. Incidence of residual defects determining the clinical outcome after TOF: Postoperative late follow-up.  Ann Thorac Surg. 1989;  47 428-435
  • 10 Van Arsdell G S, Maharaj G S, Tom J, Rao V K, Coles J G, Freedom R M, Williams W G, McCrindle B W. What is the optimal age for repair of TOF? Circulation.  2000;  102 (suppl III) III-123-III-129

1 Results were presented at the 3rd Joint Meeting of the German, Austrian and Swiss Associations of Thoracic, Cardiac and Vascular Surgery in Lucerne, Switzerland, February 9 - 12, 2000

Dr. Andreas Boening

Department of Cardiovascular Surgery
University Hospital

Arnold-Heller-Straße 7

24105 Kiel

Germany

Phone: +49 431 597-4400

Fax: +49 431 597-4402

Email: aboening@kielheart.uni-kiel.de