I have a different question, if you have someone who is younger than 18 years old, why would you refer them to an adult surgeon for any surgery if you had the option to send them to a pediatric one (unless that adult surgeon has a unique surgical niche that the pediatric one doesn't)? Heck, pediatric CT surgeons do heart surgery on 35 year old TOFs repairs, but you can bet no adult CT surgeons do TOFs repairs on 35 day olds.