Open Access

ARTICLE

Contemporary Patterns of Management of Tetralogy of Fallot: Data from a Single Center in China

by Xianchao Jiang¹, Jinyang Liu¹, Bo Peng¹, Heng Zhang², Shoujun Li¹, Jun Yan¹, Qiang Wang^1,2,*

1 Center for Pediatric Cardiac Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
2 Department of Cardiac Surgery, Yunnan Fuwai Cardiovascular Hospital, Kunming, China

* Corresponding Author: Qiang Wang. Email:

Congenital Heart Disease 2021, 16(1), 53-64. https://doi.org/10.32604/CHD.2021.013233

Received 31 August 2020; Accepted 22 October 2020; Issue published 23 December 2020

Abstract

Background: There is scarce research on large cohorts with tetralogy of Fallot (TOF) from China. The database in Fuwai Hospital was reviewed to ascertain current trends in the management of TOF and to determine the prevalence of various surgical techniques and the optimal early outcome. Methods: This cross-sectional study included 1861 patients who underwent surgery between 2012 and 2017 and were aged 0-18 years old with a primary diagnosis of TOF. A total of 1760 eligible patients were included in the analyses. Results: A total of 1683 patients underwent repair of TOF as a one-stage operation (primary repair). Sixty-one patients underwent repair of TOF after prior palliation. Of patients who underwent one-stage repair (n = 1683): 858 were 6 months to 1 year old, 421 were 1 to 2 years old, 251 were 2-18 years old, and 145 were 3 to 6 months old. Of patients who underwent repair following prior palliation (n = 61), 58 (95.1%) were older than 1 year of age. Of 1744 complete repairs, 986 (56.0%) had annulus-sparing (AS) repair. Total in-hospital mortality was 15 of 1744 (0.9%) for complete repair (including one-stage and staged repairs). The total incidence of the optimal early outcome was 78.2% in terms of a composite of the absence of death in the first year, significant right ventricular outflow tract obstruction, significant pulmonary valve insufficiency, or catheter or surgical reintervention. Conclusions: Surgical correction in patients with TOF can achieve an acceptable outcome in terms of death and reintervention. Primary repair at 6 months to 1 year of age is the most prevalent strategy in our centre. However, the relatively high incidence of early undesirable surgical adequacy of the pulmonary valve (PV) represents a wake-up call.

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