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- W2082532944 abstract "Our aim was to evaluate postoperative morbidity and mortality following initial intervention, comparing primary repair versus palliative shunt in the setting of ductal-dependent tetralogy of Fallot. When neonatal surgical intervention is required, controversy and cross-center variability exists with regard to surgical strategy. The multicenter Pediatric Health Information System database was queried to identify patients with TOF and ductal-dependent physiology, excluding pulmonary atresia. Eight hundred forty-five patients were included—349 (41.3 %) underwent primary complete repair, while 496 (58.7 %) underwent initial palliation. Palliated patients had significantly higher comorbid diagnoses of genetic syndrome and coronary artery anomalies. Primary complete repair patients had significantly increased morbidity across a number of variables compared to shunt palliation, but mortality rate was equal (6 %). Second-stage complete repair was analyzed for 285 of palliated patients, with median inter-stage duration of 231 days (175–322 days). In comparison to primary complete repairs, second-stage repairs had significantly decreased morbidity and mortality. However, cumulative morbidity was higher for the staged patients. Median adjusted billed charges were lower for primary complete repair ($363,554) compared to staged repair ($428,109). For ductal-dependent TOF, there is no difference in postoperative mortality following the initial surgery (6 %) whether management involves primary repair or palliative shunt. Although delaying complete repair by performing a palliative shunt is associated with a shift of much of the morbidity burden to outside of the newborn period, there is greater total postoperative morbidity and resource utilization associated with the staged approach." @default.
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- W2082532944 date "2014-08-28" @default.
- W2082532944 modified "2023-09-25" @default.
- W2082532944 title "Alternative Repair Strategies for Ductal-Dependent Tetralogy of Fallot and Short-Term Postoperative Outcomes, A Multicenter Analysis" @default.
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- W2082532944 doi "https://doi.org/10.1007/s00246-014-0983-6" @default.
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