{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T18:02:38Z","timestamp":1787162558618,"version":"build-2736575974"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"20","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,10,17]]},"abstract":"\n Background<\/jats:title>\n To evaluate long\u2010term outcome of tetralogy of Fallot repair analyzing an unbiased country\u2010wide surgically treated population with tetralogy of Fallot.<\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n Retrospective analysis of consecutive patients aged <18\u2009years who underwent tetralogy of Fallot repair at a single nationwide pediatric cardiac center. Death from any cause and need for surgical or catheter reintervention were the\u00a0study end points. Cox regression analysis was used to identify related risk factors. A total of 917 patients (male, 56.3%) were analyzed. Staged repair was performed in 16.9%. Early mortality (24\/917, 2.62% patients) was confined to the early surgical eras. Late mortality was 4.5% (40\/893 patients). Survival probability was 95.1%, 93.8% and 91.9% at 10, 20 and 30\u2009years after repair, respectively. Early surgical era (\n P<\/jats:italic>\n =0.013) and surgical\/catheter reinterventions (\n P<\/jats:italic>\n <0.001) were multivariable predictors of late death. A total of 487 reinterventions were performed after initial repair in 253\/917 patients (27.6%), with pulmonary artery revalvulation (196\/917 patients, 21.4%) being most frequent. Probability of freedom from first reintervention was 89.0%, 73.3%, and 55.1% at 10, 20, and 30\u2009years after primary repair, respectively. Transannular repair was associated with the need for pulmonary artery revalvulation (\n P<\/jats:italic>\n <0.001). Patients who underwent staged repair were more likely to need reinterventions on pulmonary arteries (\n P<\/jats:italic>\n <0.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n In an unbiased nationwide cohort, tetralogy of Fallot repair carried a favorable survival of >90% at 30\u2009years. Each reintervention significantly incrementally increased the risk of mortality. Type of initial repair predicted the need for specific surgical or catheter reinterventions.<\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.121.024771","type":"journal-article","created":{"date-parts":[[2023,10,12]],"date-time":"2023-10-12T06:41:16Z","timestamp":1697092876000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":15,"title":["Survival and Freedom From Reinterventions in Patients With Repaired Tetralogy of Fallot: Up to 42\u2010Year Follow\u2010Up of 917 Patients"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-0758-338X","authenticated-orcid":false,"given":"Roman","family":"Gebauer","sequence":"first","affiliation":[{"name":"Children\u2019s Heart Center, 2nd Faculty of Medicine Charles University and Motol University Hospital Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2942-9575","authenticated-orcid":false,"given":"V\u00e1clav","family":"Chaloupeck\u00fd","sequence":"additional","affiliation":[{"name":"Children\u2019s Heart Center, 2nd Faculty of Medicine Charles University and Motol University Hospital Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bohumil","family":"Hu\u010d\u00edn","sequence":"additional","affiliation":[{"name":"Children\u2019s Heart Center, 2nd Faculty of Medicine Charles University and Motol University Hospital Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0388-2390","authenticated-orcid":false,"given":"Tom\u00e1\u0161","family":"Tl\u00e1skal","sequence":"additional","affiliation":[{"name":"Children\u2019s Heart Center, 2nd Faculty of Medicine Charles University and Motol University Hospital Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8778-3762","authenticated-orcid":false,"given":"Arno\u0161t","family":"Kom\u00e1rek","sequence":"additional","affiliation":[{"name":"Department of Probability and Mathematical Statistics, Faculty of Mathematics and Physics Charles University Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4932-1150","authenticated-orcid":false,"given":"Jan","family":"Janou\u0161ek","sequence":"additional","affiliation":[{"name":"Children\u2019s Heart Center, 2nd Faculty of Medicine Charles University and Motol University Hospital Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezu401"},{"key":"e_1_3_1_3_2","first-page":"518","article-title":"Single\u2010center 50\u2009years' experience with surgical management of tetralogy of Fallot","volume":"40","author":"Lindberg HL","year":"2011","unstructured":"Lindberg HL, Saatvedt K, Seem E, Hoel T, Birkeland S. Single\u2010center 50\u2009years' experience with surgical management of tetralogy of Fallot. Eur J Cardiothorac Surg. 2011;40:518\u2013542.","journal-title":"Eur J Cardiothorac Surg"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezz270"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezz331"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.12688\/f1000research.17174.1"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2018.4255"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/jocs.14316"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2010.08.052"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-012-0537-8"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.119.008963"},{"key":"e_1_3_1_12_2","unstructured":"Therneau T (2023). A package for survival analysis in R. R package version 3.5\u20105. Available at: https:\/\/CRAN.Rproject.org\/package=survival. Accessed March 12 2023."},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezu182"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/icvts\/ivz204"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.121.024771","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T06:54:07Z","timestamp":1715583247000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.121.024771"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,17]]},"references-count":13,"journal-issue":{"issue":"20","published-print":{"date-parts":[[2023,10,17]]}},"alternative-id":["10.1161\/JAHA.121.024771"],"URL":"https:\/\/doi.org\/10.1161\/jaha.121.024771","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,17]]},"assertion":[{"value":"2022-08-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-08","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-10-12","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e024771"}}