Annual Scientific Session of the Southern Surgical Association. Palm Beach, Florida (USA), 1996/12/01.
Objective This study compares the total hospital cost (HC) for one-stage versus « two-stage » repair of tetralogy of Fallot (TOF) in infants younger than 1 year of age.
Background Data Total (one-stage) correction of TOF is now being performed with excellent results in, infancy.
Alternatively, a two-stage approach, with palliation of infants in the first year of life, followed by complete repair at a later time can be used.
In some institutions, the two-stage approach is standard practice for infants younger than 1 year of age or is used selectively in patients with an anomalous coronary artery across the right ventricular oufflow tract (RVOT), « small pulmonary arteries, » multiple congenital anomalies, critical illnesses (Cl), which increase the risk of bypass (e.g., sepsis or DIC), or severe hypercyanotic spells (HS) at the time of presentation.
The cost implications of these two approaches are unknown.
Methods The authors reviewed 22 patients younger than 1 year of age who underwent repair of TOF at their institution between 1993 and 1995.
Eighteen patients had one-stage (1°) repair (mean age, 3.4=3.1 months ; range, 3 days-9 months) and 4 patients were treated by a staged approach with initial palliation (1.6=0.4 month ; range, 1.5-2 months) followed by later repair (14.75=1.5 months ; range, 13-16 months).
The reasons for palliation were severe HS at time of presentation (two patients), anomalous coronary artery (one patient) and Cl (one patient). (...)
Mots-clés Pascal : Tétralogie Fallot, Influence, Stratégie, Réimplantation, Intervention, Multiple, Coût, Résultat, Nourrisson, Homme, Appareil circulatoire pathologie, Cardiopathie, Maladie congénitale, Chirurgie, Economie santé
Mots-clés Pascal anglais : Fallot tetralogy, Influence, Strategy, Replantation, Operation, Multiple, Costs, Result, Infant, Human, Cardiovascular disease, Heart disease, Congenital disease, Surgery, Health economy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0437924
Code Inist : 002B25F. Création : 19/12/1997.