Correction of tetralogy of Fallot: does the time period of surgery influence the outcome?
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.
Boening
A
A
Department of Cardiovascular Surgery, University Hospital, Kiel, Germany. aboening@kielheart.uni-kiel.de
Scheewe
J
J
Regensburger
D
D
Fraund
S
S
Paulsen
J
J
Kramer
H H
HH
Cremer
J
J
D000367:Age Factors; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006801:Humans; D007223:Infant; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D011183:Postoperative Complications / Q000401:mortality*; D012189:Retrospective Studies; D016019:Survival Analysis; D013771:Tetralogy of Fallot / Q000401:mortality / Q000601:surgery*