African Annals of
Thoracic and Cardiovascular Surgery

OFFICIAL PUBLICATION OF THE AFRICAN ASSOCIATION OF THORACIC AND CARDIO-VASCULAR SURGEONS
  • Abbreviation: Afr. Ann. Thorac. Cardiovasc. Surg.
  • Language: English
  • ISSN: 1994-7461
  • DOI: 10.5897/AATCVS
  • Start Year: 2005
  • Published Articles: 56

Full Length Research Paper

Use of a composite survival curve to determine the age at which surgery offers the highest survival benefit for Tetralogy of Fallot

Mark N Awori
  • Mark N Awori
  • Department of Surgery, School of Medicine, University of Nairobi, Kenyatta National Hospital, Nairobi, Kenya.
  • Google Scholar
Jonathan A Awori
  • Jonathan A Awori
  • Department of Pediatrics, Seattle Children’s Hospital, Seattle, WA, USA.
  • Google Scholar
Nick K Gachara
  • Nick K Gachara
  • Department of Surgery, School of Medicine, University of Nairobi, Kenyatta National Hospital, Nairobi, Kenya.
  • Google Scholar


  •  Received: 08 November 2021
  •  Accepted: 11 January 2022
  •  Published: 31 January 2022

Abstract

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.

Key words: Pediatric, tetralogy of Fallot, operative, outcomes.