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Tetralogy of FallotThe Spectrum of Severity in a Regional Study, 1981-1985
Sharon S. Karr, MD;
Joel I. Brenner, MD;
Christopher Loffredo, MS;
Catherine A. Neill, MD, FRCP (Lon);
Judith D. Rubin, MD, MPH
Am J Dis Child. 1992;146(1):121-124.
Abstract
• The combined medical and surgical mortality rate for 125 infants with tetralogy of Fallot registered in the Baltimore-Washington Infant Study from 1981 to 1985 was 28% (mean age at follow-up for living infants, 40 months). Despite early diagnosis and successful early repair in many infants, significant risk factors for death included pulmonary atresia, major additional cardiac anomalies, major noncardiac malformations, low birth weight, and prematurity. There is a wide spectrum of severity, ranging from infants with isolated tetralogy and no risk factors who have an excellent prognosis to infants with three or more risk factors and a high probability of neonatal death. Further treatment advances will improve outcome in some, but not all, infants. A regional all-inclusive study of a specific cardiac defect can define research and treatment challenges not obvious from selected clinical series.
(AJDC. 1992;146:121-124)
Author Affiliations
From the Children's National Medical Center, Washington, DC (Dr Karr); the Departments of Pediatrics (Drs Brenner and Rubin) and Epidemiology and Preventive Medicine (Mr Loffredo and Dr Rubin), University of Maryland School of Medicine, Baltimore; and the Department of Pediatrics, The Johns Hopkins Medical Institutions, Baltimore (Dr Neill).
Footnotes
Accepted for publication September 16, 1991.
Reprint requests to the Division of Pediatric Cardiology, University of Maryland Medical System, 22 S Greene St, Room N5W40, Baltimore, MD 21201 (Dr Brenner).
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