Staged repair versus primary repair strategy in a neonate with symptomatic tetralogy of Fallot: a systematic review
Main Article Content
Keywords
clinical outcomes, neonatal tetralogy of Fallot, primary repair, staged repair
Abstract
Introduction: The most prevalent cyanotic congenital cardiac condition is tetralogy of Fallot (TOF), which has a significant fatality rate in neonates who exhibit symptoms if treatment is not received. In this group, two surgical techniques are frequently employed: primary repair and staged repair. The best course of action is still up for dispute, though. The purpose of this study is to compare the clinical results of staged repair versus primary repair in order to assess the surgical strategy for symptomatic newborn TOF.
Methods: The PubMed, Cochrane, and ScienceDirect databases were searched for relevant material. Mortality, morbidity, duration of stay, and reintervention were among the postoperative outcomes evaluated. The Oxford Centre for Evidence-Based Medicine's recommendations were adhered to during the critical evaluation process.
Results: Seven studies were analyzed, and the results showed no discernible difference between staged and primary repair in terms of mortality or reintervention rates. Nonetheless, staged repair was linked to more expensive and prolonged hospitalizations, whereas primary repair carried a greater risk of complications.
Conclusion: It has not been demonstrated that any surgical technique is consistently better across all clinical outcomes. For high-risk newborns, such as those with low birth weight or pulmonary artery hypoplasia, staged repair seems more suitable. Individualized surgical decisions should take into account the anatomy of the patient, institutional knowledge, and the facilities that are available.
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