Objective: Right ventricular (RV) dysfunction is a significant cause of morbidity and mortality after surgical correction of tetralogy of Fallot (TOF). Transatrial/transpulmonary repair avoids a ventriculotomy (in contrast to the transventricular approach) in order to preserve the structure and function of the right ventricle. We performed a pilot prospective randomized controlled trial in infants with TOF undergoing primary repair. Methods: A pilot prospective controlled clinical trial was

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... ucted in infants with TOF undergoing primary repair between January 2008 and December 2009. One hundred and six patients were recruited in the trial and divided into a transatrialetranspulmonary approach group (Group A; n Z 53) and a transventricular approach group (Group B; n Z 53), depending on the different surgical techniques used. Results: Preoperative patient characteristics and procedure-related variables were similar. There were no deaths in Group A, while two patients died in Group B. There were significant differences in cardiopulmonary bypass time ( 95.02 AE 23.8 vs. 85.23 AE 22.63 minutes, p Z 0.032), cross-clamp time (69.4 AE 10.36 vs. 61.17 AE 9.38 minutes, p Z 0.035), inotropic support (1.63 AE 0.97 vs. 2.1 AE 1.09 days, p Z 0.02), intubation time (26.62 AE 12.48 vs. 33.02 AE 17.55 hours, p Z 0.033), duration of stay in the intensive care unit (ICU) (2.25 AE 1.28 vs. 2.85 AE 1.46 days, p Z 0.026), and the incidence of arrhythmia [3 patients (5.7%) vs. 10 patients (18.9%), p Z 0.038]. No significant differences in right/left ventricular pressure ratio and hospital stay were observed.