Impact of neonatal versus nonneonatal total repair of tetralogy of fallot on growth in the first year of life

Abstract

Background: Optimal timing for total repair in tetralogy of Fallot (TOF) is controversial. We aimed to determine if weight at 1 year differs between patients who undergo neonatal total repair versus those who undergo nonneonatal total repair later in the first year of life.

Methods: A retrospective review of infants admitted with TOF between January 2004 and June 2011 was conducted. Patient data, including weight, were collected throughout the first year of life, and neonatal total repair versus nonneonatal total repair groups were compared.

Results: Of 163 infants, neonatal total repair was undertaken in 36 (22%) of them, whereas 127 (78%) infants had nonneonatal total repair at greater than 28 days of life. The median neonatal intensive care unit length of stay (LOS) was longer for the neonatal total repair group than for the nonneonatal total repair group (17.5 [11-24] versus 7 [0-15] days; p < 0.001). Patients in the neonatal total repair group were more likely to have a transannular patch (TAP) (p < 0.001) than were those in the nonneonatal total repair group, whereas patients in the nonneonatal total repair group were more likely to have undergone a valve-sparing operation (p = 0.002). The mean weight-for-age z score was 0.7 higher in the neonatal total repair group compared with the nonneonatal total repair group (p = 0.03) controlling for birth weight (BW), diagnostic subgroup, and gestational age (GA).

Conclusions: Patients with TOF who underwent neonatal total repair were more likely to receive a TAP but had higher weight-for-age scores at 1 year compared with patients who underwent full repair later in the first year of life.