Tetralogy of Fallot in the Current Era

Only few studies have reported long-term outcome of the transatrial-transpulmonary approach in the current era of management of tetralogy of Fallot (ToF). We investigated 15-year outcome of correction via a transatrial-transpulmonary approach in a large cohort of successive patients operated in the 21st century. All infant ToF patients undergoing transatrial-transpulmonary ToF correction between 2000 and 2015 were included ( N  = 177, 106 male, median follow-up 7.1 (interquartile range 3.0–10.9) years. Data regarding postoperative complications, reinterventions, development of atrial and ventricular arrhythmia, cardiac function, and survival were evaluated. Prior shunting was performed in 10 patients (6%). The transatrial-transpulmonary approach resulted in valve-sparing surgery in 57 patients (32%). Postoperative surgical complications included junctional ectopic tachycardia ( N  = 12, 7%), pericardial ( N  = 10, 6%) or pleural effusion ( N  = 7, 3%), chylothorax ( N  = 7, 4%), bleeding requiring reoperation ( N  = 4, 3%), and superficial wound infection ( N  = 1). Fifty-one patients underwent 68 reinterventions, mainly due to pulmonary restenosis (PS) ( N  = 57). ToF correction at age P P