Do the age of patients with tetralogy of fallot at the time of surgery and the applied surgical technique influence the reoperation rate? a single-center experience.
OBJECTIVE
Primary repair of tetralogy of Fallot (TOF) has been favored in many centers for years now and results and advantages of this management seem to verify this procedure. The authors wanted to know, if the age at the time of surgery and the surgical techniques had an influence on the long-term results.


METHODS
Between 1992 and 2003, 124 patients underwent complete repair of TOF at the University Hospital Münster, Germany. Patients were subdivided into two groups based on their age (< 1 year and > 1 year of age). Patients in whom a transannular patch (TAP) was used were compared with those without (NTAP), or in whom a conduit was used.


RESULTS
Overall mortality was 8%, with an average age of death of 9.53 years (range 0.06-19.77 years). The patients' age at the time of surgery affected their survival as only two cases of death were reported among the group of children < 1 year of age (3.2%) whereas eight patients were older (12.9%; p = 0.0483). Six patients died within the first 30 days post surgery. Reoperation had to be performed in 21 cases, 13 (61.9%) of these patients were < 1 year of age at the time of surgery, eight were older (38.1%). A TAP, NTAP or conduit treatment did not show significant differences in long-term survival or freedom from reoperation.


CONCLUSIONS
Early repair of TOF within the 1st year of life can be recommended, because mortality is lower than in patients treated at a higher age. There seems no significant difference in the reintervention rate between patients treated within the 1st year of life or later.
Department of Pediatric Cardiology, University Children's Hospital Münster, Münster, Germany.
Christoph
C
Gerling
Andreas
A
Rukosujew
Hans-Gerd
HG
Kehl
Tonny D T
TD
Tjan
Andreas
A
Hoffmeier
Johannes
J
Vogt
Hans-Heinrich
HH
Scheld
Thomas
T
Krasemann
D000293:Adolescent; D017677:Age Distribution; D013504:Cardiovascular Surgical Procedures / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008297:Male; D018579:Patient Selection; D019651:Plastic Surgery Procedures / Q000706:statistics & numerical data*; D012086:Reoperation; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate; D013771:Tetralogy of Fallot / Q000401:mortality* / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult