Evidence map›Paper›PMID 40713145›Full record

ArticleJACC. Advances2025

Clinical Status and Reintervention in Neonates With Symptomatic Tetralogy of Fallot: A Landmark Analysis.

Jeffery J Meadows, Yun Zhang, Christopher J Petit, Bryan H Goldstein, Courtney E McCracken, Asaad Beshish, George T Nicholson, Mark A Law, Jeffrey D Zampi, Shabana Shahanavaz and 17 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JACC. Advances, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

27 authors.

Jeffery J MeadowsBenioff Children's Hospital, Division of Cardiology, University of California, San Francisco, California, USA. Electronic address: jeffery.meadows@ucsf.edu.
Yun ZhangChildren's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia, USA.
Christopher J PetitDivision of Cardiology, Morgan Stanley Children's Hospital of New York, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA; Children's Heart Center, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia, USA.
Bryan H GoldsteinHeart Institute, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati School of Medicine, Cincinnati, Ohio, USA; Heart Institute, UPMC Children's Hospital of Pittsburgh, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Courtney E McCrackenChildren's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia, USA.
Asaad BeshishChildren's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia, USA.
George T NicholsonDivision of Cardiology, Monroe Carrell Jr. Children's Hospital, Vanderbilt University School of Medicine, Nashville, Tennessee, USA; C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, Michigan, USA.
Mark A LawDepartment of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Jeffrey D ZampiC.S. Mott Children's Hospital, University of Michigan, Ann Arbor, Michigan, USA.
Shabana ShahanavazHeart Institute, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati School of Medicine, Cincinnati, Ohio, USA.
Paul J ChaiChildren's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia, USA.
Jennifer C RomanoSection of Pediatric Cardiothoracic Surgery, Department of Cardiac Surgery, CS Mott Children's Hospital, University of Michigan School of Medicine, Ann Arbor, Michigan, USA.
Sarosh P BatlivalaHeart Institute, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati School of Medicine, Cincinnati, Ohio, USA.
Shiraz A MaskatiaMoore Children's Heart Center, Lucille Packard Children's Hospital, Stanford University School of Medicine, Palo Alto, California, USA.
Ivor B AsztalosCardiac Center, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Hala Q KhanLillie Frank Abercrombie Section on Cardiology, Texas Children's Hospital, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.
Alicia M KamshehCardiac Center, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA; Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia, USA.
Steven J HealanDivision of Cardiology, Monroe Carrell Jr. Children's Hospital, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
Justin D SmithGolisano Children's Hospital, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.
R Allen LigonChildren's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia, USA.
Holly Bauser-HeatonChildren's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia, USA; Children's Heart Center, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia, USA.
Andrew Dailey-SchwartzLillie Frank Abercrombie Section on Cardiology, Texas Children's Hospital, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.
Joelle A PettusChildren's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia, USA.
Amy L PajkHeart Institute, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati School of Medicine, Cincinnati, Ohio, USA.
Andrew C GlatzCardiac Center, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA; Washington University Heart Center at St. Louis Children's Hospital, St. Louis, Missouri, USA.
Christopher E MascioCardiac Center, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA; Department of Cardiovascular and Thoracic Surgery, West Virginia University School of Medicine, Morgantown, West Virginia, USA.
Athar M QureshiLillie Frank Abercrombie Section on Cardiology, Texas Children's Hospital, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn symptomatic neonates with tetralogy of Fallot (sTOF), the initial treatment strategy significantly affects early outcomes, but its long-term impact remains less well defined.

objectivesThe aim of the study was to compare primary (PR) vs staged repair (SR) in sTOF with respect to reintervention (RI) rates and types, clinical and echocardiographic outcomes, and medication use.

methodsNeonates with sTOF undergoing PR or SR and with >1 year of follow-up after complete repair were included. The primary outcome was cumulative RI incidence; secondary outcomes included mortality and late echocardiographic and clinical findings. Propensity scoring adjusted for baseline differences. Landmark analysis assessed RI risk at yearly intervals following complete repair.

resultsOf 441 neonates, 182 (41%) underwent PR, and 259 (59%) underwent SR. Groups differed in gestational age, intubation, and 22q11 status. Median follow-up postrepair was 5.26 (2.91, 8.21) years. RI burden was high in both groups, with a small, consistent but nonsignificant advantage to PR. The type of RI varied over time. PR was associated with greater pulmonary insufficiency and larger pulmonary arteries. RV pressure was ≤half systemic in 80%; 10% had ≥moderate tricuspid regurgitation, without between-group difference. Elevated RV pressure was associated with ≥moderate tricuspid regurgitation.

conclusionsAmong sTOF survivors beyond the early perioperative period, late RI burden and residual hemodynamic lesions are common and largely unrelated to initial strategy. PR is associated with increased pulmonary insufficiency and pulmonary artery size.

Indexed as

congenital heart diseaselandmark analysispulmonary arterystaged repairtetralogy of Fallot

Identifiers

PMID40713145
PMCPMC12418465

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