Original articlePediatric cardiacContemporary Patterns of Management of Tetralogy of Fallot: Data From The Society of Thoracic Surgeons Database
Section snippets
Material and Methods
This study was approved by the Access and Publications Committee of the Society of Thoracic Surgeons (STS) Workforce for National Databases and the Institutional Review Board of the Montreal Children's Hospital of the McGill University Health Centre.
Operation Types and Age at Operation
There were 2534 instances of repair of TOF without a previous cardiac operation, and 217 instances of repair of TOF with a previous cardiac operation. There were 294 instances of palliation without a previous cardiac operation, and 14 instances of palliation with a previous cardiac operation.
Table 3 depicts the relationship between type of procedure and age at operation. For the neonatal age group (age 0 to 30 days), primary procedures (those without previous cardiac operations) were about
Comment
The systemic-to-pulmonary artery shunt was pioneered by Blalock in 1944, and the first intracardiac repair of TOF was accomplished by Lillehei in 1954. Shortly thereafter, Lillehei and colleagues [1, 22] introduced patch enlargement of the right ventricular infundibulum, and in 1959 Kirklin [1, 23] reported the use of transanular patching. For at least 2 decades, initial palliation followed by reparative operation later in childhood was the most prevalent strategy.
By the early 1980s, primary
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