Neonatal Repair of Tetralogy of Fallot

Symptomatic neonatal Tetralogy of Fallot: Repair or Shunt?

Kanter et al. Ann Thorac Surgery 2010;89:858-63

Neonatal repair of TOF results in improved pulmonary artery development without increased need for reintervention.

Kolcz J & Pizarro, C. Eur J Cardio-thorac Surg 2005;394-99

Long-term results in right ventricular outflow tract reconstruction in neonatal cardiac surgery: Options and outcomes.

Kaza AK, et al. 2009;138:911-16

Poor outcome was reported from Boston Children's Hospital in 1991: 14 symptomatic babies had complete repair of TOF at less than 30 days. 4/14 (28.6%) died (JTCVS 1991;101:126-37).

Better results from Michigan. (Hennein HA et al. JTCVS 1995:109:332-44). n-30, No hospital death. 25% reoperation rate in mean f-up of 15 months.

Updated data from Michigan in 2000 (Hirsch JC et al. 2000;232:508-14), report 61% freedom from reoperation at 5 yrs.

Melbourne BT shunt experience.

Twelve year experience with the modified Blalock-Taussig shunt in neonates. Eur J Thorac Cardiovasc Surg 1992;6:586-9. Nearly 100 neonates with 1 death in 10 years. Find the paper and read it.