{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:18:14Z","timestamp":1787771894750,"version":"build-2784847793"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease. Surgical correction has improved survival but re-intervention is often required.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>The objective is to assess outcomes after surgical repair of TOF, long-term follow-up, and factors that influence these results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>This is a retrospective study conducted in a tertiary care center. Records of patients diagnosed with TOF from 1992 to 2019 (37 years) were retrieved from a detailed database. Patients who underwent complete correction were grouped according to diagnosis, the technique utilized in surgical repair, need for staged repair, and syndromic association. Univariate actuarial and event-free survival analysis was performed. The endpoint for an event was death or re-intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 230 patients were diagnosed with TOF and 174 patients underwent complete surgical repair. At 40 years postoperatively, survival was 96%. Actuarial survival was independent of syndromic associations, anatomical diagnosis, type of surgery, or previous shunt. Event-free survival (EFS) survival was 8.12%. EFS was significantly worse for patients with pulmonary atresia (PA) (Hazard ratio, 4.1125; 95% confidence interval [CI], 1.2654\u201313.3657;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.0001) and for those that required homograft\/conduit. The median duration for EFS was 22.73 years, 19.58 years, and 9.12 years for transannular patch (TAP), pulmonary valve-sparing (PVS), and homograft group, respectively. The survival curve for the PVS group merged with that of TAP 20 years postoperatively. Similarly, it merged at 22 years for staged versus primary repair and at 22.73 years for syndromic versus nonsyndromic patients. A weak correlation was found between age at surgery and event-free duration (cc, 0.309;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.0001). The need for TAP was not influenced by the previous palliation, \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      (1,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 154) = 3.36,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.0667, or with interval to complete correction after the shunt procedure (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.9672).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Total correction of TOF has low perioperative mortality and good long-term survival, but the need for re-interventions is high. This study demonstrated that patients requiring homograft\/conduit and those with a diagnosis of PA had worse outcomes. Comparison between different surgical groups showed merging of survival curves in follow-up that signifies gradual loss of survival advantage over time.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/heartviews.heartviews_77_21","type":"journal-article","created":{"date-parts":[[2024,2,10]],"date-time":"2024-02-10T07:33:28Z","timestamp":1707550408000},"page":"78-85","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Long-term Outcomes of Tetralogy of Fallot in the Kingdom of Bahrain"],"prefix":"10.4103","volume":"23","author":[{"given":"Abhinav","family":"Agarwal","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suad R.","family":"Al Amer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Habib","family":"Al Tarif","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aieshah Ahmed","family":"Ismael","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulla Faisal","family":"Alshaiji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vimalarani","family":"Arulselvam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neale Nicola","family":"Kalis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-3-20240902","doi-asserted-by":"crossref","first-page":"1890","DOI":"10.1016\/S0735-1097(02)01886-7","article-title":"The incidence of congenital heart disease","volume":"39","author":"Hoffman","year":"2002","journal-title":"J Am Coll 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Is palliation \u201cold-fashioned\u201d?","volume":"9","author":"Sousa Uva","year":"1995","journal-title":"Eur J Cardiothorac Surg"},{"key":"R35-3-20240902","doi-asserted-by":"crossref","first-page":"968","DOI":"10.1016\/j.athoracsur.2005.09.033","article-title":"Genetic syndromes and outcome after surgical correction of tetralogy of Fallot","volume":"81","author":"Michielon","year":"2006","journal-title":"Ann Thorac Surg"},{"key":"R36-3-20240902","doi-asserted-by":"crossref","first-page":"868","DOI":"10.1016\/j.jtcvs.2012.12.028","article-title":"22q11.2 deletion syndrome is associated with perioperative outcome in tetralogy of Fallot","volume":"146","author":"Mercer-Rosa","year":"2013","journal-title":"J Thorac Cardiovasc Surg"},{"key":"R37-3-20240902","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1016\/j.ejcts.2010.02.030","article-title":"The long-term result of total repair for tetralogy of Fallot","volume":"38","author":"Park","year":"2010","journal-title":"Eur J Cardiothorac Surg"},{"key":"R38-3-20240902","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1093\/ejcts\/ezs221","article-title":"Preservation of right ventricular structure and function following transatrial-transpulmonary repair of tetralogy of Fallot","volume":"43","author":"Sfyridis","year":"2013","journal-title":"Eur J Cardiothorac Surg"},{"key":"R39-3-20240902","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1016\/j.jtcvs.2017.09.019","article-title":"Right ventricular outflow tract reintervention after primary tetralogy of Fallot repair in neonates and young infants","volume":"155","author":"Balasubramanya","year":"2018","journal-title":"J Thorac Cardiovasc Surg"}],"container-title":["Heart Views"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/heartviews.heartviews_77_21","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T18:19:58Z","timestamp":1787768398000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/heartviews.heartviews_77_21"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4]]},"references-count":39,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.4103\/heartviews.heartviews_77_21","relation":{},"ISSN":["1995-705X"],"issn-type":[{"value":"1995-705X","type":"print"}],"subject":[],"published":{"date-parts":[[2022,4]]}}}