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. Author manuscript; available in PMC: 2026 Oct 15.
Published before final editing as: Circ Popul Health Outcomes. 2026 Oct 13:e013189. doi: 10.1161/CIRCOUTCOMES.125.013189

National Survival Estimates after Surgical Repair of Congenital Heart Disease

Michael P Fundora 1,2, Kimberlee Gauvreau 3, Yanxu Yang 1, Jeffrey P Jacobs 4, Matthew E Oster 1,2, Kathy J Jenkins 3, Lazaros Kochilas 1,2
PMCID: PMC13665686  NIHMSID: NIHMS2214219  PMID: 42866867

Abstract

Background:

Survival estimates after congenital heart surgery (CHS) in the United States (US) are essential for planning healthcare services for this growing, resource-intensive patient population. However, the absolute number of individuals living after interventions for congenital heart disease is unknown because nationally representative survival estimates are unavailable. Understanding postoperative survival from a representative national sample is a critical first step toward estimating the size and future healthcare needs of this population. This study aimed to develop nationally representative long-term survival estimates after congenital heart surgeries (CHS) in the US, focusing on benchmark procedures defined by the Society of Thoracic Surgeons.

Methods:

We used three US datasets of children aged 0–20 years at the time of their benchmark CHS from 1998–2002 and surviving to hospital discharge. The Pediatric Cardiac Care Consortium (PCCC), a multi-institutional clinical registry, was matched to the National Death Index (NDI) to determine mortality through December 2019. The Kids’ Inpatient Database 2000 (KID), a nationally representative administrative claims dataset, was used to derive age- and sex-specific weights. Kaplan-Meier curves were estimated from the PCCC-NDI cohort for benchmark operations and KID weights were applied. Unweighted PCCC survival estimates were also compared with those Boston Children’s Hospital (BCH), a large tertiary care center

Results:

Nationally representative survival curves were generated for seven benchmark CHS from 7973 cases, 3802 (48%) were female; and 4505 (57%) were infants at the time of CHS. These weighted national survival curves closely mirrored the unweighted curves derived from PCCC-NDI. Unweighted survival estimates from PCCC also closely approximated those from BCH, with only modest differences observed for selected lesions.

Conclusions:

The weighted PCCC-NDI methodology provides the first nationally representative estimates of long-term survival after benchmark CHD in the US. These estimates provide an important resource for healthcare planning and research for the growing population of individuals with congenital heart disease.

Keywords: Congenital heart disease, Long-term survival, National estimates, Pediatric cardiac surgery, Health services research

Introduction

Congenital heart disease (CHD) is the most common type of structural birth defect, affecting approximately 1% of all births in the United States (US).1,2 Advances in the surgical management of CHD have led to a growing population of CHD survivors in the US with unique exposures and risk factors that medicine has not faced before and whose health must be monitored and appropriately supported.3,4 These patients require life-long specialized care and possibly additional interventions that only cardiac centers with expertise in the management of adults with CHD can provide. Estimates of survival after CHD operations in the US are important to plan health delivery services at the local and national level for this high resource use population. However, estimating outcomes in the absence of longitudinal national registries for CHD is challenging, as highlighted by the challenges to estimate the prevalence of CHD in the US from extrapolated data from Quebec, Canada.5 Estimates based on these data suggest there are over 2.4 million people with CHD in the US, more than half of whom are adults living with a surgically repaired or palliated CHD lesion.1,5–7 These estimates suffer from important limitations such as demographics, socioeconomic factors, environmental exposures and healthcare systems that can have a significant impact on the survival of CHD patients.8

Neither the absolute number of individuals with CHD, nor the long-term outcomes of these patients are known for the US. Understanding the long-term postoperative survival from a representative national sample is the first step in addressing the needs of this population; however, such estimates must account for differences in the distribution of patient characteristics across cardiac centers.9 This study aims to develop these estimates and address institutional differences by developing nationally-weighted survival curves using data from the Pediatric Cardiac Care Consortium (PCCC).

Methods

The data, analytic methods, and study materials will not be made available to other researchers for purposes of reproducing the results or replicating the procedure.

Study Design

This study consisted of three parts:

  1. Identification of specific pediatric cardiac surgical procedure types with acceptable matching between the clinical codes used in the PCCC- US National Death Index (NDI) registry and the ICD-9 procedure codes used in the nationally representative Kids Inpatient Database (KID).

  2. Creation of long-term, nationally representative survival curves for the surgical procedure types identified in part (1) by applying age and sex-specific weights from the KID national database to survival curves estimated from the linked PCCC-NDI dataset.

  3. Evaluation of the validity of the unweighted long-term survival estimates obtained from the PCCC-NDI data for the surgical procedure types identified in part (1) by comparing them to survival curves estimated using data from a large tertiary referral institution with established above average performance (Boston Children’s Hospital [BCH]), also linked to the NDI database.

This study was approved by the institutional review boards of Emory University and Boston Children’s Hospital, and informed consent was waived.

Data Sources

Pediatric Cardiac Care Consortium (PCCC)

The PCCC is a US-based multi-institutional registry of children undergoing congenital heart surgery (CHS) and matched to the NDI through the end of 2019 to estimate 22-year postoperative survival focused on selected surgical procedures as defined by the Society of Thoracic Surgeons Congenital Heart Surgery Database (STS-CHSD).10 It contains demographic data, cardiac diagnoses and procedures (including operations, transcatheter interventions and electrophysiologic procedures), non-cardiac diagnoses and genetic syndromes, history of previous cardiac operations, and discharge status and date.11,12 The database includes procedures performed from 1982 through 2011. More than 140,000 patients were enrolled in 48 US centers from 27 states representing multiple geographic regions within the United States and included pediatric referral centers from diverse urban and rural catchment areas. For this project, cases undergoing CHS at age ≤ 20 years during the calendar years between 1998 and 2002, residing in the US, and surviving to hospital discharge were identified. Premature infants (< 37 weeks gestational age) with PDA ligation as their only surgical procedure and patients with heart transplant as their primary surgical procedure were excluded. The resulting survival curves are then reweighted using the age and sex distributions of the nationally representative Agency for Healthcare Research and Quality (AHRQ) KID for the year 2000. This allows estimation of long-term survival for all individuals undergoing these specific types of CHS in the US.13 To further assess the validity of the unweighted PCCC survival curves, we compared them with survival curves estimated using an independent institutional cohort from BCH, a high-volume congenital heart disease center.

National Death Index (NDI)

Post-discharge deaths for the PCCC cohort were tracked by matching to the NDI, which is the standard method of mortality ascertainment in the US.14,15 The NDI database was searched for deaths at any time after hospital discharge, through December 2019.

Kids’ Inpatient Database (KID) 2000

The Healthcare Cost and Utilization Project (HCUP) KID is an administrative database of inpatient pediatric discharges. It was developed through a Federal-State-Industry partnership sponsored by AHRQ, and versions have been released every three years since 1997. KID 2000 is a sample of 2,516,833 discharges from 2784 institutions in 27 states. The American Hospital Association definitions were used to identify all non-federal, short-term, general and other specialty hospitals, including pediatric hospitals and academic medical centers. Hospital discharge datasets are collected by designated state agencies and compiled by HCUP. The KID database includes a 10% random sample of uncomplicated in-hospital births from participating institutions, and an 80% sample of complicated in-hospital births and other pediatric discharges for patients age ≤ 20 years. To obtain information that is nationally representative, the KID sample was weighted to represent the target population of pediatric discharges from all community, non-rehabilitation hospitals in the US that were operating for any part of year 2000. The KID dataset contains information typically available from hospital discharge abstracts, including patient demographics, up to 15 ICD-9-CM diagnosis codes, up to 15 procedure codes, and patient discharge status. To protect confidentiality, the KID does not contain any patient-specific identifiers.

Boston Children’s Hospital (BCH) Dataset

Patients undergoing their first palliative or corrective intervention for congenital heart disease at BCH at age ≤ 20 years during 1998–2002, residing in the US, and surviving to hospital discharge were identified from an institutional database maintained by the Department of Cardiology Clinical Research Program which includes longitudinal clinical, procedural, imaging, and outcomes data for patients treated at Boston Children’s Hospital. Premature infants (< 37 weeks gestational age) with PDA ligation as their only surgical procedure and patients with heart transplant as their primary surgical procedure were excluded. Using similar methodology to the PCCC, post-discharge deaths were tracked by linkage with the NDI. The NDI was searched through December 2019.

Identification of Congenital Heart Surgery

For calendar year 2000, selected institutions in the KID database were identified through voluntary linking with the American Hospital Association database. Using only cases from institutions contributing to both the PCCC registry and the KID database over this one year, specific CHS (such as ASD repair) were identified in the PCCC database using the registry’s specific clinical codes, and within the KID using ICD-9 diagnosis and procedure codes. For each surgical procedure with at least 10 cases identified in PCCC, the number of cases in PCCC was compared to the number identified in KID. Due to the sampling design of KID, it was expected that KID would contain approximately 80% of the total surgical admissions in PCCC. Coding for an individual procedure was considered to be acceptable in KID if the number of cases in KID was at least 70% (i.e., approximately 90% of the expected retrieval rate) of the number of cases in PCCC for those same institutions. Only surgical procedure types with acceptable matching of codes in KID to those in PCCC were used for subsequent analyses.

Creation of Long-Term Nationally Representative Survival Curves

For each surgical procedure type with validated coding, cases from the linked PCCC-NDI dataset from the five-year period 1998–2002 and meeting inclusion criteria were identified. The Kaplan-Meier method was used to estimate survival curves from the date of surgery through the end of calendar year 2019. This was done for the entire cohort, and separately for each of eight strata defined by age (0–27 days, 28–365 days, 1–5 years, 6–20 years) and sex (male, female). Next, weighting factors from the KID 2000 were identified for all cases in KID with the same surgical procedure types with validated coding to determine the relative proportions of cases within each of the eight age-sex strata in the target population of pediatric discharges from all community, non-rehabilitation hospitals in the US open for any part of year 2000. The weights corresponding to each age-sex stratum generated from KID were then applied to the stratum-specific survival estimates from PCCC-NDI, and an overall weighted average survival curve was calculated using direct standardization.16 This method provides long-term, post-discharge survival estimates based on the PCCC-NDI dataset but reweighted to the age-sex distribution of the entire US population which removes the effects of these potential confounders. (See Figure S1 for a flow chart showing how data sources were integrated)

Evaluation of Validity of the PCCC-NDI Data

For each surgical procedure type with validated coding, cases undergoing repair over the five-year period 1998–2002 were identified in the BCH-NDI dataset using Fyler procedure codes. The BCH cases were used to estimate Kaplan-Meier survival curves from time of repair through the end of calendar year 2019, analogous to PCCC. The two survival curves – PCCC and BCH – were then compared using the log-rank test.

All analyses were performed using SAS version 9.4 (SAS Institute, Cary, NC) and Stata version 17 (StataCorp, College Station, TX).

Results

Identification of Congenital Heart Surgery Types

Among the 10 institutions that contributed to both the PCCC and KID databases in the year 2000, seven CHS met the predefined threshold for acceptable matching between the clinical (PCCC) and administrative (KID) datasets: atrial septal defect (ASD) repair, ventricular septal defect (VSD) repair, coarctation repair, complete or transitional atrioventricular canal defect (AVCD) repair, total anomalous pulmonary venous connection (TAPVC) repair, tetralogy of Fallot (TOF) repair, and Stage 1 Norwood procedure (Table S1). For these CHS, KID case counts represented ≥70% of corresponding PCCC case counts, indicating strong cross-dataset consistency in procedural identification.

Long-Term Nationally Representative Survival Curves

A total of 7973 PCCC-NDI cases from 1998–2002 met inclusion criteria for the seven CHS (Table 1). Age and sex distributions varied by lesion. The percentage of cases in each of the eight age-sex strata for PCCC-NDI in 1998–2002 and for the US population in 2000 are shown in Table S2. For some procedures, such as coarctation repair, the age-sex distributions are similar; for others, like AVCD repair, they are quite different.

Table 1.

PCCC and Boston Children’s Hospital (BCH) Cases by Congenital Heart Surgery (CHS), 1998–2002

ASD Repair VSD Repair Coarctation Repair Complete or Transitional AVCD Repair TAPVC Repair TOF Repair Stage 1 Norwood Procedure
PCCC cases 2192 1018 1894 893 321 1248 407
 Age at CHS
0–27 days 17 (0.8%) 5 (0.5%) 824 (43.5%) 5 (0.6%) 198 (61.7%) 44 (3.5%) 380 (93.4%)
28–365 days 246 (11.2%) 411 (40.4%) 524 (27.7%) 803 (89.9%) 104 (32.4%) 917 (73.5%) 27 (6.6%)
1–5 years 1209 (55.2%) 421 (41.4%) 274 (14.5%) 74 (8.3%) 13 (4.1%) 239 (19.2%) 0 (0.0%)
6–20 years 720 (32.8%) 181 (17.8%) 272 (14.4%) 11 (1.2%) 6 (1.9%) 48 (3.9%) 0 (0.0%)
 Sex female 1345 (61.4%) 461 (45.3%) 705 (37.2%) 495 (55.4%) 134 (41.7%) 539 (43.2%) 123 (30.2%)
BCH cases 125 90 149 72 34 93 148
 Age at CHS
0–27 days 0 (0.0%) 2 (2.2%) 75 (50.3%) 3 (4.2%) 19 (55.9%) 15 (16.1%) 138 (93.2%)
28–365 days 12 (9.6%) 45 (50.0%) 36 (24.2%) 67 (93.1%) 13 (38.2%) 75 (80.7%) 10 (6.8%)
1–5 years 59 (47.2%) 31 (34.4%) 26 (17.5%) 2 (2.8%) 1 (2.9%) 1 (1.1%) 0 (0.0%)
6–20 years 54 (43.2%) 12 (13.3%) 12 (8.1%) 0 (0.0%) 1 (2.9%) 2 (2.2%) 0 (0.0%)
 Sex female 83 (66.4%) 35 (38.9%) 48 (32.2%) 38 (52.8%) 14 (41.2%) 46 (49.5%) 50 (33.8%)
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The numbers within parenthesis express the percentage of patients by columns among PCCC and BCH cases respectively.

PCCC=Pediatric cardiac care consortium, BCH=Boston Children’s Hospital, ASD=atrial septal defect, VSD=Ventricular septal defect, AVCD= atrioventricular canal, TAPVC=total anomalous pulmonary venous connection, TOF=tetralogy of Fallot

When applying age and sex weights from the KID national dataset to generate nationally representative survival curves, the weighted curves were nearly identical to the unweighted PCCC-NDI curves across all seven CHS (Figure 1). No procedure showed substantive divergence between weighted and unweighted estimates, indicating that the PCCC long-term outcomes have validity after reweighting for the nationally expected age-sex distributions.

Figure 1.

Figure 1.

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Long-term Survival after Seven Benchmark Congenital Heart Surgeries: Pediatric Cardiac Care Consortium (PCCC) Estimates versus Estimates Reweighted to the United States Population. Kaplan-Meier survival curves from the Pediatric Cardiac Care Consortium-National Death Index (PCCC-NDI) cohort are shown before and after age- and sex- based reweighting using the Kids’ Inpatient Database (KID). This figure illustrates differences in survival that would be expected if the PCCC-NDI cohort had the same age and sex distribution as the U.S. population in 2000. No statistical comparisons are performed. ASD, Atrial Septal Defect; AVCD, Atrioventricular canal defect; TAPVC, Total Anomalous Pulmonary Venous Connection; TOF, Tetralogy of Fallot; VSD, Ventricular Septal Defect.

Comparison of PCCC and BCH Survival Curves

To further evaluate validity, the original unweighted survival curves from PCCC–NDI were compared to those from BCH for the same procedures and era (1998–2002). During this time period, a total of 711 cases from BCH corresponded to the 7973 cases from the PCCC cohort as described above (Table 1). Unadjusted long-term survival was similar between datasets for VSD, AVCD, TAPVC and TOF repairs (Figure 2), but slightly higher in PCCC cohort for ASD repair (p<0.001), coarctation repair (p=0.016), and Stage 1 Norwood procedure (p=0.021). Taken together, these findings suggest that the PCCC-NDI survival curves are broadly representative of long-term outcomes observed in a large contemporary referral center.

Figure 2.

Figure 2.

Open in a new tab

Long-term Survival after Seven Congenital Heart Surgeries: Pediatric Cardiac Care Consortium-National Death Index (PCCC-NDI) versus Boston Children’s Hospital (BCH) cohorts. Unadjusted Kaplan-Meier survival curves are shown for the PCCC-NDI and BCH cohorts. Survival estimates were similar for ventricular septal defect (VSD), atrioventricular canal defect (AVCD), total anomalous pulmonary venous connection (TAPVC) and tetralogy of Fallot (TOF) repairs. Modest differences were observed for atrial septal defect (ASD) repair (p<0.001), coarctation repair (p=0.016), and Stage 1 Norwood procedure (p=0.021).

Discussion

The number of individuals living with CHD in the US continues to grow, and many require life-long specialized care delivered by resource-intensive cardiac centers. Generating accurate estimates of long-term postoperative survival is therefore critical for effectively planning health care needs at the local and national level.17 In this study, we used procedures with strong coding agreement between the long standing clinical registry of the PCCC and the KID national dataset to create nationally weighted survival curves. These reweighted curves closely mirrored the PCCC survival estimates produced by the long-term outcomes project matching the PCCC with the NDI18,19 suggesting that the PCCC-NDI generated estimates are nationally representative and can therefore be used to assess the long-term postoperative survival estimate for patients living after CHS in the US. These findings open a new avenue for further research into the long-term outcomes of patients with CHD in the US.

Researchers in other countries with access to longitudinal registries, have highlighted how information about long-term outcomes can be useful to educate patients, families and healthcare providers, as well as plan for the healthcare needs of patients with CHD.20–23 Although useful, data from outside of the US reflect different educational systems, environmental exposures, and social support systems and their findings may not be generalizable to the US healthcare system and patients. A US-specific long-term survival resource is, therefore, essential. However, the US lacks a comprehensive, longitudinal, population-based registry of CHD survivors. In that regard, PCCC is uniquely positioned to fill this gap since it is the only multi-center registry collecting data for all interventions for CHD since the early 1980s and for 30 consecutive years, and is the only source of information for patients operated on during that time.24 Between the start of the PCCC registry in 198211 and until the last enrollment in 2011, more than 140,000 patients have been enrolled from 47 US centers in 27 states. These patients underwent 264,256 operations, which depending on the year represent between 15 to 30% of the estimated national total. The PCCC reported outcomes are comparable to the other available clinical and administrative datasets that have been capturing different aspects of the care of patients with CHD in equivalent eras.12,25,26 To successfully develop a national estimate of survival, estimates had to account for differences in the distribution of patient characteristics across cardiac centers to obtain nationally weighted estimates.5,9,27–29 By applying direct standardization using sex- and age-specific weights derived from KID, our study adjusts for known differences in procedural case mix across institutions an established requirement for producing national benchmark survival estimates. After applying the age-sex distributions for the nationwide cohort based on the participants in the weighted KID database to the long-term survival estimates of the PCCC cohort, we observed no differences in outcomes for seven specific, common congenital cardiac lesions, demonstrating that the PCCC-NDI based survival curves may be considered an effective estimate of national outcomes. Considering the similarity of the weighted survival curves from the PCCC database, it is likely that survival curves from other lesions in PCCC may also be nationally representative.

Our U.S. estimates are similar to findings from European cohorts. In a population-based Norwegian study of over 7,000 patients, survival to 16 years for complex lesions increased from 62.4% in 1971–1989 to 86.9% in 1990–2011..30 A Finnish study of over 10,000 patients demonstrated a long-term survival of 87% for simple defects versus 65% for severe defects from cohorts from 1953–2009, showing improved survival amongst simple and severe lesions in the 1990–2009 cohort at 20 years.21 The PCCC-NDI cohort showed a similar trend in survival among simple and severe defects in a similar time period (1998–2002). However, these European cohorts are from homogeneous populations with centralized surgical care which limits the extrapolation of their findings to the decentralized, heterogenous U.S. healthcare system emphasizing the importance of a U.S.-specific, nationally representative cohort describing the long-term outcomes of children with CHD.

We further assessed the validity of the PCCC by comparing PCCC-based survival with survival from a large tertiary referral center, BCH, with well-established institutional experience.28,29,31 Long-term survival estimates from the PCCC-NDI cohort generally paralleled those observed at BCH, supporting the external validity of the PCCC-based estimates. Modest differences observed for selected lesions (ASD, coarctation, Stage I Norwood) likely reflect differences in referral patterns, case complexity, and matching techniques that are not fully captured by available covariates, rather than systematic limitations of the PCCC-NDI linkage methodology.

The study has certain limitations. First, its registry-based nature limits clinical details to what was tracked by the PCCC and the KID registry. Race and socioeconomic status are incompletely captured in PCCC with race being available only for ~34% of long-term survivors: 81.3% White, 16.1% Black and 2.6% other race vs 76.9%, 13.3% and 9.8% respectively. As result, extrapolations of estimates may not be accurate for race and ethnicity groups with small number of subjects.32,33 Additionally, residual defects, suboptimal hemodynamics or complications can have long-term implications and are not adequately tracked by either registry. Such information is available by the clinical dataset at BCH but without being available in the other sources, it is not possible to be used in this setting.

Second, this study is limited by incomplete matching between codes from PCCC and KID and constraints inherent to matching with the NDI. These include variability in death documentation, changes in ICD coding over time, and differences in availability of direct identifiers for matching between institutions.34 Furthermore, any potential sample bias may be inherent to the limitations of the design. The unexpectedly smaller number of matched VSD cases likely reflects the conservative matching strategy used to align the highly specific clinical registry codes in PCCC with ICD-9 administrative coding in the KID dataset. This may have introduced lesion-specific selection bias, particularly for heterogeneous conditions such as VSDs, where administrative coding may not adequately distinguish isolated from more complex forms of disease or fully capture differences in operative management. Additionally, although the cohort included institutions from several U.S. regions, some geographic areas were underrepresented, which may limit the generalizability of the findings to all U.S. congenital heart surgery populations.

Considering the limitations of the alternatives, the NDI remains the best data source available in the U.S. for tracking long-term mortality in geographically diverse cohorts.35 Prior validation work in the PCCC has demonstrated high specificity (>99.5%) and strong sensitivity for identifying deaths after congenital heart interventions. For example, sensitivity for death ascertainment was 88.1% (95% CI: 87.1–89.0%) among patients with in-hospital deaths and complete identifiers, but even higher among patients reaching the Fontan procedure was even higher at 94.7% (95% CI: 94.4–95.1%).18,36 Although minor variations existed for specific diagnoses (e.g., coarctation), linkage performance was not significantly affected by CHD subtype overall.

Finally, results may be limited by evolving surgical techniques and medical management since the era examined (1998–2002). Although absolute survival estimates may differ for modern cohorts, long-term projection outcomes for this era remain highly relevant for today’s population of adult CHD patients and will likely improve previously available projections of US national estimates.5

Conclusion

This study demonstrates the validity of the PCCC-NDI dataset as a national estimate of survival after CHS in the US, with only minor corrections or adjustments needed for specific lesions or CHS. Establishing this validity unlocks the potential of the PCCC-NDI matched cohort for studying long-term outcomes of patients operated for CHD in the US and allowing more accurate projections of patients surviving after CHS and their long-term healthcare resource needs.

Supplementary Material

Supplemental_Publication_Material

Figures S1

Tables S1-S2

What is Known:

  • Long-term survival after congenital heart surgery in the US is difficult to estimate because no national longitudinal clinical registry exists.

  • Most published survival data come from single-center cohorts, limiting generalizability and healthcare planning.

  • Clinical registries such as the Pediatric Cardiac Care Consortium provide multi-center follow-up data but are not nationally representative.

What the study adds:

  • An age- and sex- weighting approach using the Kids Inpatient Sample generates nationally representative long-term survival estimates from the PCCC-NDI dataset.

  • The weighted national survival estimates closely match the original PCCC-NDI estimates and closely approximate those from an independent tertiary congenital heart center.

  • This methodology provides the first nationally representative long-term survival estimates after benchmark congenital heart surgery in the US.

Funding / Support:

This study was supported by the National Heart, Lung, and Blood Institute (NHLBI) R01 (HL122392), and the Department of Defense (PR180683).

Non-standard Abbreviations and Acronyms

PCCC

Pediatric Cardiac Care Consortium

CHS

Congenital heart surgery

CHD

Congenital heart disease

NDI

National Death Index

KID

Kids’ Inpatient Database 2000

BCH

Boston Children’s Hospital

STS-CHSD

Society of Thoracic Surgeons Congenital Heart Surgery Database

AHRQ

Agency for Healthcare Research and Quality

HCUP

Healthcare Cost and Utilization Project

ASD

Atrial septal defect

VSD

Ventricular septal defect

AVCD

Complete or transitional atrioventricular canal defect

TAPVC

Total anomalous pulmonary venous connection

TOF

Tetralogy of Fallot

Footnotes

Disclosures: The authors do not have any relationships relevant to the content of this paper to disclose. All authors have approved the final version of the article.

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