Grant: Project Grant

Tetralogy of Fallot is a severe heart malformation requiring open heart surgery in infancy. With the surgery, patients can often live relatively normal lives well into their teens and adulthood. However, some will eventually require a second surgery to replace one of the valves in their heart. Although this second surgery is common, physicians do not yet know the best time to offer it to their patients. On the one hand, we know that waiting too long may cause irreparable damage to the heart. On the other hand, doing it too early may not benefit the patient, who would then have had unnecessary surgery. Although this second surgery is performed in up to 10% of children with tetralogy of Fallot, there are no studies to help us know whether it is truly beneficial for the long-term health of these patients. Therefore, we must work to identify clues which can inform physicians about the ideal timing for valve replacement. This would ensure that the surgery is offered to the right patient, at the right time. We will create a database containing the relevant information of all the patients with tetralogy of Fallot in Quebec. With this database, we aim to answer these key questions: - How many children with tetralogy of Fallot require a second heart surgery? - Are there details in the medical history of patients with tetralogy of Fallot that increase their risk of needing more than one surgery? - When patients have no symptom but have abnormal medical test results, does the second surgery have a positive impact on their health? - Are there clues that can help physicians identify patients who would benefit from a second surgery, and those who would not? The goal of our project is to improve our understanding of the impact and ideal timing of valve replacement so that physicians offer the operation only when the patient needs it the most, while sparing others from unnecessary surgery. This will have a major influence on both their health and quality of life.