Intersurgeon variability in long-term outcomes after transatrial repair of tetralogy of Fallot: 25 years' experience with 675 patients

The Journal of Thoracic and Cardiovascular Surgery
Yves d'UdekemChristian P Brizard

Abstract

To compare the long-term reoperation rates among surgeons performing transatrial repair of tetralogy of Fallot. The data set of 675 patients undergoing transatrial repair of tetralogy of Fallot at 1 institution from 1980 to 2005 was analyzed for intersurgeon differences in the reoperation rates. A follow-up period >15 years was available for 5 surgeons, allowing for comparison (541 patients; >80 patients/surgeon). The reintervention rate at 10 years varied from 8.8% (95% confidence interval [CI], 5.3%-14.5%) to 26.7% (95% CI, 14.9%-44.9%; hazard ratio, 3.4; P = .001). The procedures of 1 surgeon resulted in a reoperation rate of 10.5% at 20 years (95% CI, 5.4%-25.3%). The type of reoperation required varied among the surgeons. One surgeon had had no reoperations for pulmonary artery stenosis. Of the 5 surgeons, 2 (surgeons 2 and 5) had equivalent overall 10-year reoperation rates (24.1%, 95% CI, 12.9%-42.3%; vs 26.7%, 95% CI, 14.9%-44.9%; P = .32). Surgeon 5 had reoperation almost exclusively for right ventricular outflow tract obstruction (20.6%; 95% CI, 12.4%-33.1%) and surgeon 2 for right ventricular dilation (17.4%; 95% CI, 7.8%-36.3%). None of the patients treated by surgeon 5 required implantation of a valved conduit. An ...Continue Reading

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Citations

Sep 7, 2014·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Atsushi Mizuno, Koichiro Niwa
Nov 29, 2016·Congenital Heart Disease·Maryanne Caruana, Victor Grech
May 27, 2017·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Jana LogotetaHans-Heiner Kramer
Aug 31, 2018·World Journal for Pediatric & Congenital Heart Surgery·Yves d'Udekem
Dec 25, 2019·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Eva van den BoschWillem A Helbing
Jun 13, 2021·Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual·David J Barron, Anusha Jegatheeswaran
Mar 28, 2021·The Annals of Thoracic Surgery·Yasuyuki KobayashiShingo Kasahara

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