{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:23:24Z","timestamp":1787840604788,"version":"build-2784847793"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The optimal management of neonates with tetralogy of Fallot (TOF) and unfavorable anatomy remains debated. Early primary repair carries risks, while palliative options such as right ventricular outflow tract (RVOT) stenting have emerged as effective alternatives to conventional shunts. However, outcomes of corrective surgery following RVOT stenting remain underexplored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods:<\/jats:title>\n                    <jats:p>\n                      A retrospective study was done on 11 patients with TOF who underwent RVOT stenting followed by surgical repair between April 2021 and March 2025, from a total of 619 TOF surgeries. Data on demographics, intraoperative findings, pulmonary artery (PA) growth, and postoperative outcomes, including 30-day mortality, were collected. PA growth was assessed via\n                      <jats:italic toggle=\"yes\">z<\/jats:italic>\n                      -scores pre- and poststenting. The correlation between time from stenting to surgery and operative duration was evaluated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The median age and weight at surgery were 31 months and 10.2 kg, respectively. Complete stent excision was possible in 91% of patients. Transannular patch repair was required in 90.9% of cases. Prestent PA\n                      <jats:italic toggle=\"yes\">z<\/jats:italic>\n                      -scores improved significantly by the time of surgery (left PA: \u22121.92 to \u20130.11; right PA: \u22122.95 to \u22120.46). Maximum PA growth occurred within 5 months poststenting. An increased interval between stenting and surgery correlated with prolonged cardiopulmonary bypass and aortic cross-clamp times. No in-hospital mortality or 30-day mortality occurred; the median ventilation was 12.7 h, and the mean intensive care unit stay was 2.1 days.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Corrective surgery after RVOT stenting in TOF is safe and feasible, with favorable early outcomes. Early repair \u2013 preferably within 5 months of RVOT stenting \u2013 facilitates optimal PA growth and minimizes surgical complexity. Larger, prospective studies are warranted to standardize timing and assess long-term outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/apc.apc_272_25","type":"journal-article","created":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T12:00:16Z","timestamp":1773662416000},"page":"551-556","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Surgical outcomes of repair for tetralogy of Fallot with a previous right ventricular outflow tract stent"],"prefix":"10.4103","volume":"18","author":[{"given":"Debasis","family":"Das","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, Narayana Superspeciality Hospital, Howrah (Narayana Health), Kolkata, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanulina","family":"Sarkar","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Narayana Superspeciality Hospital, Howrah (Narayana Health), Kolkata, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shubhadeep","family":"Das","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiac Intensive Care, Narayana Superspeciality Hospital, Howrah (Narayana Health), Kolkata, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Varsha","family":"Malladi","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Narayana Superspeciality Hospital, Howrah (Narayana Health), Kolkata, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manish Kumar","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Cardiac Anaesthesia, Narayana Superspeciality Hospital, Howrah (Narayana Health), Kolkata, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shivani","family":"Gajpal","sequence":"additional","affiliation":[{"name":"Department of Cardiac Anaesthesia, Narayana Superspeciality Hospital, Howrah (Narayana Health), Kolkata, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amitabha","family":"Chattopadhyay","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, Narayana Superspeciality Hospital, Howrah (Narayana Health), Kolkata, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,3,16]]},"reference":[{"key":"R1-20260416","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4103\/apc.apc_228_24","article-title":"Determining the optimal timing for tetralogy of Fallot management: A meta-analysis of neonatal versus postneonatal repairs","volume":"18","author":"Rampengan","year":"2025","journal-title":"Ann Pediatr 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stenosis","volume":"15","author":"Prabhu","year":"2022","journal-title":"Ann Pediatr Cardiol"},{"key":"R11-20260416","doi-asserted-by":"crossref","first-page":"281","DOI":"10.4103\/apc.APC_168_16","article-title":"Stenting of right ventricular outflow tract in tetralogy of Fallot with subarterial ventricular septal defect: A word of caution","volume":"10","author":"Lee","year":"2017","journal-title":"Ann Pediatr Cardiol"},{"key":"R12-20260416","doi-asserted-by":"crossref","first-page":"1985","DOI":"10.1136\/heartjnl-2016-310620","article-title":"Right ventricular outflow tract stent versus BT shunt palliation in tetralogy of Fallot","volume":"103","author":"Quandt","year":"2017","journal-title":"Heart"},{"key":"R13-20260416","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1017\/S1047951121001505","article-title":"Surgical versus transcatheter palliation for insufficient pulmonary blood supply in infants with cyanotic CHD","volume":"32","author":"Ho","year":"2022","journal-title":"Cardiol Young"},{"key":"R14-20260416","first-page":"125","article-title":"Right ventricular outflow tract stenting in severe tetralogy of Fallot: An option to the Blalock-Taussig shunt","volume":"87","author":"Peirone","year":"2019","journal-title":"Rev Argent Cardiol"},{"key":"R15-20260416","first-page":"105","article-title":"Anomalous coronary artery in tetralogy of Fallot-feasibility of right ventricular outflow tract stenting as initial palliation","volume":"100","author":"Afifi","year":"2022","journal-title":"Catheter Cardiovasc Interv"},{"key":"R16-20260416","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1161\/CIRCULATIONAHA.117.029987","article-title":"Comparison between patent ductus arteriosus stent and modified Blalock-Taussig shunt as palliation for infants with ductal-dependent pulmonary blood flow: Insights from the congenital catheterization research 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