Congenital cardiac anomalies: one-stage repair in infancy

Abstract

A proposed preferred treatment plan consisting of one-stage operative repair of congenital cardiac anomalies whenever complete correction was feasible and operative intervention required was tested during the period February 1, 1972, to September 15, 1974. Experience with 74 patients aged 14 hours to 24 months allows some conclusions to be made regarding the advisability of this approach. For patients with ventricular defect and tetralogy of Fallot, this approach has quite acceptable results and certainly is more direct than palliative operations and second-stage repair. The hypothesis is more difficult to justify in patients with transposition of the great arteries. By avoiding repair in patients under 4 months of age and using a better technique for placement of the intraatrial partition, improved results are anticipated. In the miscellaneous group of anomalies, results depend upon the complexity of the defect and the ability to achieve accurate anatomical correction. After an early mortality of 20% and some late deaths, survival and improvement resulted in 51 of these babies. These results justify persistence in the choice of one-stage correction when operative intervention is required.