Background: 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. Patients and Methods: 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 z -scores pre- and poststenting. The correlation between time from stenting to surgery and operative duration was evaluated. Results: 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 z -scores improved significantly by the time of surgery (left PA: −1.92 to –0.11; right PA: −2.95 to −0.46). 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. Conclusions: Corrective surgery after RVOT stenting in TOF is safe and feasible, with favorable early outcomes. Early repair – preferably within 5 months of RVOT stenting – facilitates optimal PA growth and minimizes surgical complexity. Larger, prospective studies are warranted to standardize timing and assess long-term outcomes.
Das et al. (Sat,) studied this question.