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Contemporary surgical practice relating to Tetralogy of Fallot is shifting towards earlier correction; however, a recent large study proposes later correction to increase event free survival. Surgery aims to improve the quantity and quality of life at minimal risk to the patient. Surgical outcome and risk assessment requires a comparison of externally valid studies of natural history and surgical outcome. The authors reviewed the literature to identify the most externally valid natural history and surgical outcome data and used it to develop a composite survival graph to help clinicians determine when surgery would offer the greatest survival advantage. The composite graph suggests that, for symptomatic patients, the greatest survival advantage occurs when corrective surgery is performed within the 1st week of life.
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Mark et al. (2022) studied this question.
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