Title : Right ventricular outflow tract sparing versus annulus-sparing with Right ventricular
Objectives: The aim of this study was to assess the impact of right ventricular outflow tract sparing (RVOT-sparing) versus annulus-sparing (AS) with the use of RVOT incision on outcomes after complete repair for tetralogy of Fallot (CR-TOF).
Methods: This is a retrospective cohort study. Consecutive patients who underwent CR-TOF at a single institution in China were included and compared according to RVOT-sparing versus AS with RVOT incision. The primary endpoint was defined as a composite of death, or reintervention, or significant annular peak gradient (APG), or significant pulmonary regurgitation (PR). We compared outcomes in patients who received RVOT-sparing with those in patients who received AS with RVOT incision, using a multivariable Cox model with inverse probability weighting according to the propensity score.
Results: From January 2012 to December 2017, of 1733 patients undergoing CR-TOF, 743 patients repaired by transannular patch (TAP) with RVOT incision and 1 patient repaired by AS with RVOT incision suffering from in-hospital death were excluded from the analysis. Of the remaining 989 patients, during a median follow-up duration of 48 months, 176 patients (17.8%) had a primary end-point event. In the main analysis, there was no significant association between RVOT-sparing use and the primary outcome (hazard ratio, 0.48, 95% confidence