Association of tetralogy of Fallot and complete atrioventricular canal: a single-centre 40-year experience

Association of tetralogy of Fallot and complete atrioventricular canal: a single-centre 40-year experience

Abstract OBJECTIVES Outcome data in tetralogy of Fallot (ToF) and complete atrioventricular canal (CAVC) are limited. We report our experience for over 40 years in this patient population. METHODS Single-centre, retrospective analysis of patients who underwent surgical repair with the diagnosis of T...

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Veröffentlicht in:European journal of cardio-thoracic surgery 2024-02, Vol.65 (2)
Hauptverfasser: Fernandez-Cisneros, Alejandro, Staffa, Steven J, Emani, Sitaram M, Chávez, Mariana, Friedman, Kevin G, Hoganson, David M, Kaza, Aditya K, Del Nido, Pedro J, Baird, Christopher W
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container_title European journal of cardio-thoracic surgery
container_volume 65
creator Fernandez-Cisneros, Alejandro
Staffa, Steven J
Emani, Sitaram M
Chávez, Mariana
Friedman, Kevin G
Hoganson, David M
Kaza, Aditya K
Del Nido, Pedro J
Baird, Christopher W
description Abstract OBJECTIVES Outcome data in tetralogy of Fallot (ToF) and complete atrioventricular canal (CAVC) are limited. We report our experience for over 40 years in this patient population. METHODS Single-centre, retrospective analysis of patients who underwent surgical repair with the diagnosis of ToF-CAVC from 1979 to 2022, divided into 2 different periods and compared. RESULTS A total of 116 patients were included: 1979–2007 (n = 61) and 2008–2021 (n = 55). Balanced CAVC (80%) and Rastelli type C CAVC (81%) were most common. Patients in the later era were younger (4 vs 14 months, P 
doi_str_mv 10.1093/ejcts/ezae037
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We report our experience for over 40 years in this patient population. METHODS Single-centre, retrospective analysis of patients who underwent surgical repair with the diagnosis of ToF-CAVC from 1979 to 2022, divided into 2 different periods and compared. RESULTS A total of 116 patients were included: 1979–2007 (n = 61) and 2008–2021 (n = 55). Balanced CAVC (80%) and Rastelli type C CAVC (81%) were most common. Patients in the later era were younger (4 vs 14 months, P &lt; 0.001), fewer had trisomy 21 (60% vs 80%, P = 0.019) and fewer had prior palliative prior procedures (31% vs 43%, P &lt; 0.001). In the earlier era, single-patch technique was more common (62% vs 16%, P &lt; 0.001), and in recent era, double-patch technique was more common (84% vs 33%, P &lt; 0.001). In the earlier era, right ventricular outflow tract was most commonly reconstructed with transannular patch (51%), while in more recent era, valve-sparing repairs were more common (69%) (P &lt; 0.001). In-hospital mortality was 4.3%. The median follow-up was 217 and 74 months for the first and second eras. Survival for earlier and later eras at 2-, 5- and 10-year follow-up was (85.1%, 81.5%, 79.6% vs 94.2%, 94.2%, 94.2% respectively, log-rank test P = 0.03). CONCLUSIONS The surgical approach to ToF-CAVC has evolved over time. More recently, patients tended to receive primary repair at younger ages and had fewer palliative procedures. Improved surgical techniques allowing for earlier and complete repair have shown a decrease in mortality, more valve-sparing procedures without an increase in total reoperations. Presented at the 37th EACTS Annual Meeting, Vienna, Austria. The association between complete atrioventricular canal (CAVC) and tetralogy of Fallot (ToF) is a seldom condition occurring in 0.68–1.8% of newborns with Trisomy 21 [1] This association is seen in 1.7% of patients with ToF and in 5–10% of patients with CAVC [2, 3] Traditionally this entity has been regarded as a surgical and medical challenge with associated high mortality and morbidity.</description><identifier>ISSN: 1873-734X</identifier><identifier>EISSN: 1873-734X</identifier><identifier>DOI: 10.1093/ejcts/ezae037</identifier><identifier>PMID: 38310341</identifier><language>eng</language><publisher>Germany: Oxford University Press</publisher><ispartof>European journal of cardio-thoracic surgery, 2024-02, Vol.65 (2)</ispartof><rights>The Author(s) 2024. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. 2024</rights><rights>The Author(s) 2024. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c282t-89a4296692ffa7cdbd57e4e08a8781be2b1067302cc15ea1d2065062c8ccb1433</cites><orcidid>0000-0001-9901-7408 ; 0000-0003-4252-8789 ; 0000-0002-7588-7596 ; 0000-0003-3450-4496 ; 0000-0002-8141-7793 ; 0000-0002-6048-2078 ; 0000-0002-3180-9764</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,778,782,27907,27908</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38310341$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fernandez-Cisneros, Alejandro</creatorcontrib><creatorcontrib>Staffa, Steven J</creatorcontrib><creatorcontrib>Emani, Sitaram M</creatorcontrib><creatorcontrib>Chávez, Mariana</creatorcontrib><creatorcontrib>Friedman, Kevin G</creatorcontrib><creatorcontrib>Hoganson, David M</creatorcontrib><creatorcontrib>Kaza, Aditya K</creatorcontrib><creatorcontrib>Del Nido, Pedro J</creatorcontrib><creatorcontrib>Baird, Christopher W</creatorcontrib><title>Association of tetralogy of Fallot and complete atrioventricular canal: a single-centre 40-year experience</title><title>European journal of cardio-thoracic surgery</title><addtitle>Eur J Cardiothorac Surg</addtitle><description>Abstract OBJECTIVES Outcome data in tetralogy of Fallot (ToF) and complete atrioventricular canal (CAVC) are limited. We report our experience for over 40 years in this patient population. METHODS Single-centre, retrospective analysis of patients who underwent surgical repair with the diagnosis of ToF-CAVC from 1979 to 2022, divided into 2 different periods and compared. RESULTS A total of 116 patients were included: 1979–2007 (n = 61) and 2008–2021 (n = 55). Balanced CAVC (80%) and Rastelli type C CAVC (81%) were most common. Patients in the later era were younger (4 vs 14 months, P &lt; 0.001), fewer had trisomy 21 (60% vs 80%, P = 0.019) and fewer had prior palliative prior procedures (31% vs 43%, P &lt; 0.001). In the earlier era, single-patch technique was more common (62% vs 16%, P &lt; 0.001), and in recent era, double-patch technique was more common (84% vs 33%, P &lt; 0.001). In the earlier era, right ventricular outflow tract was most commonly reconstructed with transannular patch (51%), while in more recent era, valve-sparing repairs were more common (69%) (P &lt; 0.001). In-hospital mortality was 4.3%. The median follow-up was 217 and 74 months for the first and second eras. Survival for earlier and later eras at 2-, 5- and 10-year follow-up was (85.1%, 81.5%, 79.6% vs 94.2%, 94.2%, 94.2% respectively, log-rank test P = 0.03). CONCLUSIONS The surgical approach to ToF-CAVC has evolved over time. More recently, patients tended to receive primary repair at younger ages and had fewer palliative procedures. Improved surgical techniques allowing for earlier and complete repair have shown a decrease in mortality, more valve-sparing procedures without an increase in total reoperations. Presented at the 37th EACTS Annual Meeting, Vienna, Austria. The association between complete atrioventricular canal (CAVC) and tetralogy of Fallot (ToF) is a seldom condition occurring in 0.68–1.8% of newborns with Trisomy 21 [1] This association is seen in 1.7% of patients with ToF and in 5–10% of patients with CAVC [2, 3] Traditionally this entity has been regarded as a surgical and medical challenge with associated high mortality and morbidity.</description><issn>1873-734X</issn><issn>1873-734X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNqFkE1Lw0AQhhdRbP04epU9eondjzSbeCvFqlDwouAtTDaTkrLJxt2NWH-9qa0fN08zw_vwDjyEXHB2zVkmJ7jWwU_wA5BJdUDGPFUyUjJ-Ofyzj8iJ92vGWCKFOiYjmUrOZMzHZD3z3uoaQm1baisaMDgwdrXZHgswxgYKbUm1bTqDASkEV9s3bIehewOOamjB3FCgvm5XBiO9zZDGLNrgEON7h67GVuMZOarAeDzfz1PyvLh9mt9Hy8e7h_lsGWmRihClGcQiS5JMVBUoXRblVGGMLIVUpbxAUXCWKMmE1nyKwEvBkilLhE61Lngs5Sm52vV2zr726EPe1F6jMdCi7X0uMpFxyVXGBjTaodpZ7x1WeefqBtwm5yzf6s2_9OZ7vQN_ua_uiwbLH_rb5-9v23f_dH0Ce-aG-Q</recordid><startdate>20240201</startdate><enddate>20240201</enddate><creator>Fernandez-Cisneros, Alejandro</creator><creator>Staffa, Steven J</creator><creator>Emani, Sitaram M</creator><creator>Chávez, Mariana</creator><creator>Friedman, Kevin G</creator><creator>Hoganson, David M</creator><creator>Kaza, Aditya K</creator><creator>Del Nido, Pedro J</creator><creator>Baird, Christopher W</creator><general>Oxford University Press</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-9901-7408</orcidid><orcidid>https://orcid.org/0000-0003-4252-8789</orcidid><orcidid>https://orcid.org/0000-0002-7588-7596</orcidid><orcidid>https://orcid.org/0000-0003-3450-4496</orcidid><orcidid>https://orcid.org/0000-0002-8141-7793</orcidid><orcidid>https://orcid.org/0000-0002-6048-2078</orcidid><orcidid>https://orcid.org/0000-0002-3180-9764</orcidid></search><sort><creationdate>20240201</creationdate><title>Association of tetralogy of Fallot and complete atrioventricular canal: a single-centre 40-year experience</title><author>Fernandez-Cisneros, Alejandro ; Staffa, Steven J ; Emani, Sitaram M ; Chávez, Mariana ; Friedman, Kevin G ; Hoganson, David M ; Kaza, Aditya K ; Del Nido, Pedro J ; Baird, Christopher W</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c282t-89a4296692ffa7cdbd57e4e08a8781be2b1067302cc15ea1d2065062c8ccb1433</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fernandez-Cisneros, Alejandro</creatorcontrib><creatorcontrib>Staffa, Steven J</creatorcontrib><creatorcontrib>Emani, Sitaram M</creatorcontrib><creatorcontrib>Chávez, Mariana</creatorcontrib><creatorcontrib>Friedman, Kevin G</creatorcontrib><creatorcontrib>Hoganson, David M</creatorcontrib><creatorcontrib>Kaza, Aditya K</creatorcontrib><creatorcontrib>Del Nido, Pedro J</creatorcontrib><creatorcontrib>Baird, Christopher W</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of cardio-thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fernandez-Cisneros, Alejandro</au><au>Staffa, Steven J</au><au>Emani, Sitaram M</au><au>Chávez, Mariana</au><au>Friedman, Kevin G</au><au>Hoganson, David M</au><au>Kaza, Aditya K</au><au>Del Nido, Pedro J</au><au>Baird, Christopher W</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association of tetralogy of Fallot and complete atrioventricular canal: a single-centre 40-year experience</atitle><jtitle>European journal of cardio-thoracic surgery</jtitle><addtitle>Eur J Cardiothorac Surg</addtitle><date>2024-02-01</date><risdate>2024</risdate><volume>65</volume><issue>2</issue><issn>1873-734X</issn><eissn>1873-734X</eissn><abstract>Abstract OBJECTIVES Outcome data in tetralogy of Fallot (ToF) and complete atrioventricular canal (CAVC) are limited. We report our experience for over 40 years in this patient population. METHODS Single-centre, retrospective analysis of patients who underwent surgical repair with the diagnosis of ToF-CAVC from 1979 to 2022, divided into 2 different periods and compared. RESULTS A total of 116 patients were included: 1979–2007 (n = 61) and 2008–2021 (n = 55). Balanced CAVC (80%) and Rastelli type C CAVC (81%) were most common. Patients in the later era were younger (4 vs 14 months, P &lt; 0.001), fewer had trisomy 21 (60% vs 80%, P = 0.019) and fewer had prior palliative prior procedures (31% vs 43%, P &lt; 0.001). In the earlier era, single-patch technique was more common (62% vs 16%, P &lt; 0.001), and in recent era, double-patch technique was more common (84% vs 33%, P &lt; 0.001). In the earlier era, right ventricular outflow tract was most commonly reconstructed with transannular patch (51%), while in more recent era, valve-sparing repairs were more common (69%) (P &lt; 0.001). In-hospital mortality was 4.3%. The median follow-up was 217 and 74 months for the first and second eras. Survival for earlier and later eras at 2-, 5- and 10-year follow-up was (85.1%, 81.5%, 79.6% vs 94.2%, 94.2%, 94.2% respectively, log-rank test P = 0.03). CONCLUSIONS The surgical approach to ToF-CAVC has evolved over time. More recently, patients tended to receive primary repair at younger ages and had fewer palliative procedures. Improved surgical techniques allowing for earlier and complete repair have shown a decrease in mortality, more valve-sparing procedures without an increase in total reoperations. Presented at the 37th EACTS Annual Meeting, Vienna, Austria. The association between complete atrioventricular canal (CAVC) and tetralogy of Fallot (ToF) is a seldom condition occurring in 0.68–1.8% of newborns with Trisomy 21 [1] This association is seen in 1.7% of patients with ToF and in 5–10% of patients with CAVC [2, 3] Traditionally this entity has been regarded as a surgical and medical challenge with associated high mortality and morbidity.</abstract><cop>Germany</cop><pub>Oxford University Press</pub><pmid>38310341</pmid><doi>10.1093/ejcts/ezae037</doi><orcidid>https://orcid.org/0000-0001-9901-7408</orcidid><orcidid>https://orcid.org/0000-0003-4252-8789</orcidid><orcidid>https://orcid.org/0000-0002-7588-7596</orcidid><orcidid>https://orcid.org/0000-0003-3450-4496</orcidid><orcidid>https://orcid.org/0000-0002-8141-7793</orcidid><orcidid>https://orcid.org/0000-0002-6048-2078</orcidid><orcidid>https://orcid.org/0000-0002-3180-9764</orcidid></addata></record>
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title Association of tetralogy of Fallot and complete atrioventricular canal: a single-centre 40-year experience
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