[Early one-stage repair of tetralogy of Fallot].

Objective: To evaluate the outcome after early, primary repair of Tetralogy of Fallot (TOF) in children under 6 months of age.
Methods: 74 infants, who underwent repair of TOF between 1992 and 2003, aged from 1.5 to 6 months, were investigated. 32 (43%) patients were cyanotic, 14 (18%) had anoxemic spells. Most of them were qualified for surgical procedure by echocardiographic study only, 26 patients required cardiac catheterisation. Two had balloon angioplasty prior to primary repair. None of them underwent initial palliation. Mean follow-up was 4.9 years (1 -9.5 years).
Results: 71 children survived and they were in good condition. 3 patients died (mortality 3.6%). One child required reoperation. Transannular patch (TAP) was inserted in 66% of patients. Right ventricular outflow tract obstruction (RVOTO) more than 40 mmHg occurred in 2 infants. Moderate pulmonary insufficiency was present in 38 infants (25%). None of the patients had QRS complex longer than 140 msec.
Conclusions: Early one-stage repair of TOF was achieved with low mortality rate and low risk for reoperation (1.5%). It eliminates initial palliation and drug therapy.