Palliation Strategy to Achieve Complete Repair in Symptomatic Neonates with Tetralogy of Fallot

Neonates with symptomatic tetralogy of Fallot (sTOF) may undergo palliations with varying physiology, namely systemic to pulmonary artery connections (SPC) or right ventricular outflow tract interventions (RVOTI). A comparison of palliative strategies based on the physiology created is lacking. Cons...

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Bibliographic Details
Published in:Pediatric cardiology 2022-10, Vol.43 (7), p.1587-1598
Main Authors: Law, Mark A., Glatz, Andrew C., Romano, Jennifer C., Chai, Paul J., Mascio, Christopher E., Petit, Christopher J., McCracken, Courtney E., Kelleman, Michael S., Nicholson, George T., Meadows, Jeffery J., Zampi, Jeffrey D., Shahanavaz, Shabana, Batlivala, Sarosh P., Pettus, Joelle, Pajk, Amy L., Hock, Kristal M., Goldstein, Bryan H., Qureshi, Athar M.
Format: Article
Language:English
Subjects:
Cardiac Surgery
Cardiology
Medicine
Medicine & Public Health
Original Article
Vascular Surgery
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Summary:Neonates with symptomatic tetralogy of Fallot (sTOF) may undergo palliations with varying physiology, namely systemic to pulmonary artery connections (SPC) or right ventricular outflow tract interventions (RVOTI). A comparison of palliative strategies based on the physiology created is lacking. Consecutive sTOF neonates undergoing SPC or RVOTI from 2005–2017 were reviewed from the Congenital Cardiac Research Collaborative. The primary outcome was survival with successful complete repair (CR) by 18 months. A variety of secondary outcomes were assessed including overall survival, hospitalization-related comorbidities, and interstage reinterventions. Propensity score adjustment was utilized to compare treatment strategies. The cohort included 252 SPC (surgical shunt = 226, ductus arteriosus stent = 26) and 68 RVOTI (balloon pulmonary valvuloplasty = 48, RVOT stent = 11, RVOT patch = 9) patients. Genetic syndrome (29 [42.6%] v 75 [29.8%], p  = 0.04), weight 
ISSN:0172-0643
1432-1971
DOI:10.1007/s00246-022-02886-0