[Long-term results following surgical treatment of tetralogy of Fallot].
The few published long-term studies regarding survival after corrective surgery of tetralogy of Fallot are based on patients operated 15 to 30 years ago during the developmental phase of the corrective technique. Interpretation of the results and conclusions for the present time based on these interpretations are thus difficult. It should be possible, however, to improve the reported life expectancy of less than 90% after 15 to 30 years for those who survived corrective surgery. Preservation of myocardial function, especially that of the right ventricle is most important for the improvement of life expectancy. Influencing factors are - besides degree of severity and duration of preoperative overload - residual defects, sequela and complications. The classical residual defects such as ventricular septal defect or stenosis of the right ventricular outflow tract are rarely observed today. Cardiac complications such as AV-block and arrhythmia may not always be preventable; local and diffuse fibrotic alterations of the right ventricular myocardium are probably the cause, which in turn may be induced by ventriculotomy, infundibulectomy as well as pressure overload and hypoxemia. Duration of overload is most likely the main contributing factor. The most important sequela is the postoperative pulmonary insufficiency. The larger the volume overload the more pronounced is the impairment of right myocardial function. Allograft implantation appears to be the most promising technique to prevent pulmonary insufficiency at the present time.
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Klinik für Angeborene Herzfehler/Kinderkardiologie im Deutschen Herzzentrum Berlin.
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D011183:Postoperative Complications / Q000401:mortality*; D013771:Tetralogy of Fallot / Q000401:mortality / Q000601:surgery*
Langzeitergebnisse nach chirurgischer Behandlung Fallotscher Tetralogien.