{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T06:53:10Z","timestamp":1785480790772,"version":"3.56.0"},"reference-count":26,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2019,10,11]],"date-time":"2019-10-11T00:00:00Z","timestamp":1570752000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>OBJECTIVES<\/jats:title><jats:p>Repair of Tetralogy of Fallot (TOF) has currently excellent results with either transventricular or transatrial approach. However, it is unclear as to which has better late outcomes and what role of residual pulmonary valve (PV) regurgitation in the long term is. We report on late clinical outcomes after repair in a large series of patients with TOF, focusing on the type of surgical technique.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>This analysis is a retrospective multicentre study on patients undergoing TOF repair in infancy. The exclusion criteria of the study were TOF with pulmonary atresia or absent PV.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>We selected 720 patients who had undergone TOF repair (median age 5.7\u2009months, interquartile range 3.7\u201311.7). Preoperative cyanotic spells occurred in 18%. A transatrial repair was performed in 433 (60.1%) patients. The PV was preserved in 249 (35%) patients, while the right ventricular outflow tract was reconstructed with a transannular patch (60.4%) or a conduit (4.6%) in the rest of the patients. At a median follow-up of 4\u2009years (range 1\u201321, 86% complete), 10 (1.6%) patients died, while 39 (6.3%) patients required surgical reoperation and 72 (11.7%) patients required an interventional procedure. The propensity match analysis showed that the incidence of postoperative complications and adverse events at follow-up were significantly increased in patients undergoing transventricular approach repair with transannular patch (P\u2009=\u20090.006) and PV preservation was a significant protective factor against postoperative complications (P\u2009=\u20090.009, odds ratio 0.5) and late adverse events (P\u2009=\u20090.022).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Surgical repair of TOF in infancy is a safe procedure, with good late clinical outcomes. However, transatrial approach and PV preservation at repair are associated with lower early and late morbidity.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ejcts\/ezz270","type":"journal-article","created":{"date-parts":[[2019,9,13]],"date-time":"2019-09-13T11:40:23Z","timestamp":1568374823000},"source":"Crossref","is-referenced-by-count":12,"title":["The role of primary surgical repair technique on late outcomes of Tetralogy of Fallot: a multicentre study"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7535-9670","authenticated-orcid":false,"given":"Massimo A","family":"Padalino","sequence":"first","affiliation":[{"name":"Pediatric and Congenital Cardiac Surgery Unit, Department of Cardiac Thoracic, Vascular Sciences and Public Health, University of Padova Medical School, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Pradegan","sequence":"additional","affiliation":[{"name":"Pediatric and Congenital Cardiac Surgery Unit, Department of Cardiac Thoracic, Vascular Sciences and Public Health, University of Padova Medical School, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danila","family":"Azzolina","sequence":"additional","affiliation":[{"name":"Biostatistics, Epidemiology and Public Health Unit, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padua, Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2420-1555","authenticated-orcid":false,"given":"Lorenzo","family":"Galletti","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Giovanni XXIII Hospital, Bergamo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7039-5309","authenticated-orcid":false,"given":"Carlo","family":"Pace Napoleone","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiac Surgery, Regina Margherita Hospital, Torino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"Agati","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Centro Mediterraneo, Taormina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaetano","family":"Palma","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, University of Napoli Federico II, Napoli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano Maria","family":"Marianeschi","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiac Surgery, Ca Granda Niguarda Hospital, Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Seddio","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Giovanni XXIII Hospital, Bergamo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Teresa","family":"Cascarano","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiac Surgery, Regina Margherita Hospital, Torino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Carro","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiac Surgery, Ca Granda Niguarda Hospital, Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7906-0580","authenticated-orcid":false,"given":"Dario","family":"Gregori","sequence":"additional","affiliation":[{"name":"Biostatistics, Epidemiology and Public Health Unit, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padua, Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vladimiro Lorenzo","family":"Vida","sequence":"additional","affiliation":[{"name":"Pediatric and Congenital Cardiac Surgery Unit, Department of Cardiac Thoracic, Vascular Sciences and Public Health, University of Padova Medical School, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Stellin","sequence":"additional","affiliation":[{"name":"Pediatric and Congenital Cardiac Surgery Unit, Department of Cardiac Thoracic, Vascular Sciences and Public Health, University of Padova Medical School, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,10,11]]},"reference":[{"key":"2019101109584765700_ezz270-B1","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/S0096-5588(20)30094-5","article-title":"Surgical treatment for the tetralogy of Fallot by open intracardiac repair","volume":"37","author":"Kirklin","year":"1959","journal-title":"J Thorac Surg"},{"key":"2019101109584765700_ezz270-B2","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1093\/ejcts\/ezs478","article-title":"Results of reparative surgery for tetralogy of Fallot: data 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