What are the differences in outcomes between a strategy of staged repair (SR) (initial palliation [IP] and subsequent complete repair [CR]) as compared with primary repair (PR) for infants with symptomatic tetralogy of Fallot (sTOF)?

The authors concluded that when adjusted for patient-related factors, early mortality and neonatal morbidity were lower in patients undergoing staged repair, while cumulative morbidity and reinterventions favored the primary repair group, suggesting potential benefits to each strategy.

A multicenter retrospective cohort study was performed. The study population included consecutive neonates with sTOF who underwent IP or PR at ≤30 days of age between 2005 and 2017 at the nine centers participating in the Congenital Cardiac Research Collaborative.

A total of 572 patients were studied, of which 343 patients underwent SR and 230 underwent PR. For patients undergoing SR, the initial procedure was surgical in 256 and transcatheter in 86.

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