Thoracic and Cardiovascular Surgery Surgery for Congenital Heart Disease Cardiac Status and Health-related Quality of Life in the Long Term after Surgical Repair of Tetralogy of Fallot in Infancy and Childhood

CARDIAC STATUS AND HEALTH-RELATED QUALITY OF LIFE IN THE LONG TERM AFTER SURGICAL REPAIR OF TETRALOGY OF FALLOT IN INFANCY AND CHILDHOOD The long-term results of surgical repair of tetralogy of Fallot were assessed by means of extensive cardiologic examination of 77 nonselected patients 14.7 -+ 2.9 years after surgical repair of tetralogy of Fallot in infancy and childhood. Because of the frequent use of a transannular patch (56%) for the relief of right ventricular outflow tract obstruction, the prevalence of elevated right ventricular systolic pressure was low (8%), but the prevalence of substantial right ventricular dilation with severe pulmonary regurgitation was high (58%). The exercise capacity of patients with a substantially dilated right ventricle proved to be significantly decreased (83% --19% of predicted) when compared with that of patients with a near normal sized right ventricle (96% 13%). Eight out of 10 patients who had needed treatment for symptomatic arrhythmia had supraventricular arrhythmia, which makes supraventricular arrhythmia~in numbers--a more important sequela in the long-term survivors than ventricular arrhythmia. Older age at the time of the operation and longer duration of follow-up were not associated with an increase in prevalence or clinical significance of sequelae. (J THORAC CARDIOVASC SURG 1995;110:883-91)