The American Association for Thoracic Surgery (AATS) 2022 Expert Consensus Document: Management of infants and neonates with tetralogy of Fallot

被引:28
作者
Miller, Jacob R. [1 ]
Stephens, Elizabeth H. [3 ]
Goldstone, Andrew B. [4 ]
Glatz, Andrew C. [2 ]
Kane, Lauren [5 ]
Arsdell, Glen S. [6 ]
Stellin, Giovanni [7 ]
Barron, David J. [8 ]
d'Udekem, Yves [10 ]
Benson, Lee [9 ]
Quintessenza, James [11 ]
Ohye, Richard G. [12 ]
Talwar, Sachin [13 ]
Fremes, Stephen E. [14 ]
Emani, Sitaram M. [15 ,16 ]
Eghtesady, Pirooz [1 ]
机构
[1] Dept Surg Washington Univ, St Louis Childrens Hosp, Sch Med, Sect Pediat Cardiothorac Surg,Dept Surg, St Louis, MO USA
[2] Washington Univ, St Louis Childrens Hosp, Sch Med, Dept Pediat Cardiol,Div Pediat, St Louis, MO USA
[3] Mayo Clin, Dept Cardiovasc Surg, Rochester, MN USA
[4] Columbia Univ, Div Cardiothorac Surg, Sect Congenital & Pediat Cardiac Surg, New York, NY USA
[5] Transmedics Inc, Andover, MA USA
[6] UCLA, Dept Surg, Div Cardiothorac Surg, Mattel Childrens Hosp, Los Angeles, CA USA
[7] Univ Padua, Med Sch, Dept Cardiac Thorac & Vasc Sci, Pediat & Congenital Cardiac Surg Unit, Padua, Italy
[8] Hosp Sick Children, Cardiovasc Surg, Toronto, ON, Canada
[9] Hosp Sick Children, Pediat Cardiol, Toronto, ON, Canada
[10] Childrens Natl Hosp, Childrens Natl Heart Inst, Div Cardiac Surg, Washington, DC USA
[11] Johns Hopkins All Childrens Heart Inst, Dept Cardiovasc Surg, St Petersburg, FL USA
[12] Univ Michigan, Med Sch, Dept Cardiac Surg, Sect Pediat Cardiovasc Surg, Ann Arbor, MI USA
[13] All India Inst Med Sci, Dept Cariothorac & Vasc Surg, New Delhi, India
[14] Univ Toronto, Schulich Heart Ctr, Sunnybrook Hlth Sci Ctr, Dept Surg,Div Cardiac Surg, Toronto, ON, Canada
[15] Boston Childrens Hosp, Dept Cardiovasc Surg, Boston, MA USA
[16] Boston Childrens Hosp, Dept Cardiovasc Surg, 320 Longwood Ave, Boston, MA 02115 USA
关键词
BLALOCK-TAUSSIG SHUNT; CONGENITAL HEART-DISEASE; ABNORMAL CORONARY-ARTERY; BALLOON PULMONARY VALVULOPLASTY; TRANSANNULAR PATCH PLACEMENT; OUTFLOW TRACT RECONSTRUCTION; RIGHT-VENTRICULAR FUNCTION; DUCTUS-ARTERIOSUS STENT; VALVE-SPARING REPAIR; LOW-BIRTH-WEIGHT;
D O I
10.1016/j.jtcvs.2022.07.025
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: Despite decades of experience, aspects of the management of tetralogy of Fallot with pulmonary stenosis (TOF) remain controversial. Practitioners must consider newer, evolving treatment strategies with limited data to guide decision sioned by the American Association for Thoracic Surgery to provide a framework on this topic, focused on timing and types of interventions, management of highrisk patients, technical considerations during interventions, and best practices for assessment of outcomes of the interventions. In addition, the group was tasked with identifying pertinent research questions for future investigations. It is recognized that variability in institutional experience could influence the application of this framework to clinical practice. Methods: The TOF Clinical Practice Standards Committee is a multinational, multidisciplinary group of cardiologists and surgeons with expertise in TOF. With the assistance of a medical librarian, a citation search in PubMed, Embase, Scopus, and Web of Science was performed using key words related to TOF and its management; the search was restricted to the English language and the year 2000 or later. Articles pertaining to pulmonary atresia, absent pulmonary valve, atrioventricular septal defects, and adult patients with TOF were excluded, as well as nonprimary sources such as review articles. This yielded nearly 20,000 results, of which 163 were included. Greater consideration was given to more recent studies, larger studies, and those using comparison groups with randomization or propensity score matching. Expert consensus statements with class of recommendation and level of evidence were developed using a modified Delphi method, requiring 80% of the member votes with 75% agreement on each statement. Results: In asymptomatic infants, complete surgical correction between age 3 and 6 months is reasonable to reduce the length of stay, rate of adverse events,
引用
收藏
页码:221 / 250
页数:30
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