Incidence of residual defects determining the clinical outcome after correction of tetralogy of Fallot: postoperative late follow-up.
The postoperative results in 150 patients who had repair of tetralogy of Fallot (mean follow-up, 10.2 +/- 2.6 years) were defined as good in 71.3%, fair in 20.7%, and unsatisfactory in 8.0% on the basis of clinical criteria. Ninety-six percent of the patients are socially active, 92.0% have a good exercise tolerance, and 79.3% participate in sports. Data from 78 postoperative hemodynamic studies show mild right ventricular dysfunction in almost all patients examined. Peak systolic right ventricular/left ventricular pressure ratio decreased in the postoperative period in 65.4% of patients, remained unchanged in 3.8%, and increased in 30.8%. Minimal residual anomalies can modify the prognosis substantially. Of our patients, 53.3% of those with a shunt (p less than 0.05), 37.5% of those with stenosis (not significant), and 53.8% of those with pulmonary incompetences (p = not significant) have fair or unsatisfactory results. The associated defects are particularly unfavorable. Rhythm and conduction disturbances have resulted in fair or unsatisfactory results in 65.1% of patients. Such a disturbance occurring soon after bypass must be considered an incremental risk factor: 52.9% of patients seen with rhythm and conduction disturbances show the same disturbances later (p less than 0.001).
Calza
G
G
Department of Cardiovascular Surgery, Istituto Giannina Gaslini, Genova, Italy.
Panizzon
G
G
Rovida
S
S
Aigueperse
J
J
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D006439:Hemodynamics; D006801:Humans; D010297:Paris; D010807:Physical Endurance; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology*; D011379:Prognosis; D011788:Quality of Life; D012307:Risk Factors; D013771:Tetralogy of Fallot / Q000150:complications / Q000503:physiopathology* / Q000601:surgery; D013997:Time Factors