The impact of the tetralogy of Fallot primary correction technique on the frequency of reinterventions

The aim – to analyze the types of reinterventions after the total repair of tetralogy of Fallot and identify the factors influencing the risk of reoperations.Materials and methods. This study presents a single-center retrospective analysis of long-term outcomes of 1,441 total repair of tetralogy of Fallot performed from 2000 to 2023. The median patient age was 9,8 [3.3; 128] months (ranging from 0.1 to 204 months), and the median weight was 10.1 [3.3; 57] kg (ranging from 3.3 to 70 kg). Associated cardiac pathologies were diagnosed in 43,1 % of patients, while genetic anomalies were identified in 6.3 %. The TAP technique (the transannular patch) was applied in 61.2 % of cases, whereas NTAP (the non-transannular patch) – in 38.8 %. The overall mortality rate following primary total repair was 3.46 %. The long-term follow-up period averaged 107.3 ± 54.7 months (ranging from 13 to 241 months).Results. Surgical and percutaneous reintervention procedures (n = 320) were performed in 225 (16.5 %) patients, on average, 89.7±49.7 months (ranging from 8.7 to 204 months) after total repair. The most common indications for repeat procedures included pulmonary valve insufficiency requiring conduit implantation in the pulmonary artery position (53.3 %), pulmonary valve and branch stenosis (47.97 %), and residual right ventricular outflow tract obstruction (39.1 %).Conclusions. Correlation analysis revealed that the use of TAP is an independent risk factor for repeat surgeries (r = 0.726, p < 0.001). Meanwhile, the valve-sparing technique for right ventricular outflow tract obstruction repair in tetralogy of Fallot is associated with a lower risk of pulmonary valve insufficiency and the need for conduit implantation during long-term period.