Main indications and long-term outcomes of reoperation after initial repair of tetralogy of Fallot

Background and Objective: The aim of this study was to analyze our indications, surgical procedures, and clinical outcomes of patients undergoing reoperation after surgical correction of tetralogy of Fallot (TOF). Methods: Thirty seven consecutive patients who underwent reoperation late after intra-cardiac repair of TOF within a period of 10 years were assessed. Results: The most common indications for correcting TOF was pulmonary valve insufficiency (51.4%) followed by right ventricular outflow tract (RVOT) dilatation (45.9%), residual ventricular septal defect (VSD) (43.2%), pulmonary valve stenosis (32.4%) and pulmonary artery stenosis (32.4%). The most common late complication for primary operation included pulmonary insufficiency (5.4%), followed by ventricular tachycardia (5.4%). Late complication rate following reoperation was 13.5%. There were three operative deaths with a mortality rate of 8.1%. One-year and three-year survival were 96.2% and 91.8%, respectively. Late mortality following reoperation was significantly higher in those with underlying coronary artery anomaly (p= 0.026), those with primary patent ductus arteriosus (PDA) (p= 0.026), and those with pulmonary stenosis (p= 0.028) as indications for repeated operation. Conclusion: The most common indications of redo surgery following TOF repairing surgery are pulmonary valve insufficiency followed by RVOT dilatation, and residual VSD. Although the redo surgery is associated with serious complications, acceptable long-term survival following this repeated operation is expectable.