When is the Best Time for Corrective Surgery in Patients with Tetralogy of Fallot between 0 and 12 Months of Age?

Abstract Objective: To identify the best time for corrective surgery of tetralogy of Fallot (TF) in children aged 0-12 months and to report the most frequent complications during the first 3 years postoperatively. Methods: Systematic review of studies published between 2000 and 2017 on corrective surgery for TF. Articles were selected through search of electronic databases (PubMed, SciELO, Scopus, Lilacs, Google Scholar, and Cochrane). Length of stay in intensive care unit, duration of mechanical ventilation, and peri/postoperative complications were analyzed for data discussion and research interpretation. Conclusion: Definitive corrective surgery is the best alternative, and the earlier it is performed, the lower the occurrence of harmful effects and the greater the chances of cardiorespiratory recovery. This systematic review suggests that the best time to perform definitive corrective surgery for TF in the first year of life is during 3-6 months of age in children with no or mild symptoms. Children with severe symptoms should undergo surgery immediately.

摘要 目的：明确0~12月龄儿童法洛四联症（Tetralogy of Fallot, TF）根治手术的最佳时机，并报告术后前3年最常见的并发症。方法：对2000年至2017年间发表的关于TF根治手术的相关研究进行系统评价。通过检索PubMed、SciELO、Scopus、Lilacs、Google Scholar及Cochrane等电子数据库筛选文献，分析重症监护病房（Intensive Care Unit, ICU）住院时长、机械通气时长及围手术期/术后并发症，以开展数据讨论与研究解读。结论：根治性手术为最优治疗方案，且手术实施越早，不良事件发生率越低，心肺康复的可能性越高。本系统评价提示，对于无症状或症状轻微的患儿，出生后1年内行TF根治手术的最佳时机为3~6月龄；症状严重的患儿应立即接受手术治疗。