Clinical Status and Reintervention in Neonates With Symptomatic Tetralogy of Fallot
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Le résumé fourni par la source
BACKGROUND: In symptomatic neonates with tetralogy of Fallot (sTOF), the initial treatment strategy significantly affects early outcomes, but its long-term impact remains less well defined. OBJECTIVES: The aim of the study was to compare primary (PR) vs staged repair (SR) in sTOF with respect to reintervention (RI) rates and types, clinical and echocardiographic outcomes, and medication use. METHODS: Neonates with sTOF undergoing PR or SR and with >1 year of follow-up after complete repair were included. The primary outcome was cumulative RI incidence; secondary outcomes included mortality and late echocardiographic and clinical findings. Propensity scoring adjusted for baseline differences. Landmark analysis assessed RI risk at yearly intervals following complete repair. RESULTS: Of 441 neonates, 182 (41%) underwent PR, and 259 (59%) underwent SR. Groups differed in gestational age, intubation, and 22q11 status. Median follow-up postrepair was 5.26 (2.91, 8.21) years. RI burden was high in both groups, with a small, consistent but nonsignificant advantage to PR. The type of RI varied over time. PR was associated with greater pulmonary insufficiency and larger pulmonary arteries. RV pressure was ≤half systemic in 80%; 10% had ≥moderate tricuspid regurgitation, without between-group difference. Elevated RV pressure was associated with ≥moderate tricuspid regurgitation. CONCLUSIONS: Among sTOF survivors beyond the early perioperative period, late RI burden and residual hemodynamic lesions are common and largely unrelated to initial strategy. PR is associated with increased pulmonary insufficiency and pulmonary artery size.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Clinical Status and Reintervention in Neonates With Symptomatic Tetralogy of Fallot
- Date Crossref
- 01/07/2025
- Éditeur
- Elsevier BV
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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UCSF Benioff Children's Hospital pays non établi dans la noticeÉtablissement de santé
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Emory University Children's Healthcare of Atlanta pays non établi dans la noticeUniversité ou école supérieure
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Children's Healthcare of Atlanta pays non établi dans la noticeÉtablissement de santé
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Morgan Stanley Children's Hospital pays non établi dans la noticeÉtablissement de santé
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Cincinnati Children's Hospital Medical Center pays non établi dans la noticeÉtablissement de santé
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Children's Hospital of Pittsburgh pays non établi dans la noticeÉtablissement de santé
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Monroe Carell Jr. Children's Hospital pays non établi dans la noticeÉtablissement de santé
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C. S. Mott Children's Hospital pays non établi dans la noticeÉtablissement de santé
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University of Alabama at Birmingham Department of Pediatrics pays non établi dans la noticeUniversité ou école supérieure
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University of Michigan C.S. Mott Children's Hospital pays non établi dans la noticeUniversité ou école supérieure
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University of Cincinnati Heart Institute pays non établi dans la noticeUniversité ou école supérieure
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Lucile Packard Children's Hospital pays non établi dans la noticeÉtablissement de santé
UCSF Benioff Children's Hospital, Children's Healthcare of Atlanta — Emory University et Children's Healthcare of Atlanta, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.