Abstract
ObjectiveTo identify the best time for corrective surgery of tetralogy of Fallot (TF) in children aged 0-12 months and to report the most frequent complications during the first 3 years postoperatively.MethodsSystematic review of studies published between 2000 and 2017 on corrective surgery for TF. Articles were selected through search of electronic databases (PubMed, SciELO, Scopus, Lilacs, Google Scholar, and Cochrane). Length of stay in intensive care unit, duration of mechanical ventilation, and peri/postoperative complications were analyzed for data discussion and research interpretation.ConclusionDefinitive corrective surgery is the best alternative, and the earlier it is performed, the lower the occurrence of harmful effects and the greater the chances of cardiorespiratory recovery. This systematic review suggests that the best time to perform definitive corrective surgery for TF in the first year of life is during 3-6 months of age in children with no or mild symptoms. Children with severe symptoms should undergo surgery immediately.
Highlights
This systematic review suggests that the best time to perform definitive corrective surgery for Tetralogy of Fallot (TF) in the first year of life is during 3-6 months of age in children with no or mild symptoms
Tetralogy of Fallot (TF) is the most common cyanogenic congenital heart disease (CHD) occurring after the first year of life and it accounts for approximately 10% of all CHD[1]
We considered peri- and postoperative mortality and complications, such as duration of extracorporeal circulation (ECC), arrhythmias, ventricular dysfunction, and pulmonary insufficiency and/or stenosis requiring surgical reintervention, to conclude which is the best time for this operation
Summary
Tetralogy of Fallot (TF) is the most common cyanogenic congenital heart disease (CHD) occurring after the first year of life and it accounts for approximately 10% of all CHD[1]. The natural history of TF is quite variable and is determined by the type and degree of obstruction of the RV outflow tract Most patients, such as infants, are asymptomatic, but if they are not treated surgically, only 10% will survive beyond the age of 20 years[2]. Consequences of progressive hypoxemia and acquired changes, such as hypoplasia of the pulmonary arteries and RV and development of collateral systemic pulmonary circulation, will occur. These late changes are the reasons why corrective surgery is being performed earlier and earlier
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