Total intracardiac repair of the adult cyanotic tetralogy of Fallot: clinical experience and late follow-up.
Twenty-seven adult patients with the cyanotic type of tetralogy of Fallot had total intracardiac repair during the past five years at the Toronto General Hospital. Twenty-one of 27 patients (77%) had had a previous shunting operation performed five to 21 years prior to the total intracardiac repair. Seventeen of 21 (81%) of these anastomoses were patent at the time of the total intracardiac repair. The hospital mortality was 11% and was attributable to hemorrhage - a well-recognized problem in adult tetralogy, due to excessive collateral circulation. All 24 surviving patients followéd up from six months to five years showed marked clinical improvement, with disappearance of the cyanosis and reduction in acne and clubbing. Permanent heart block has not occurred. Late hemodynamic studies showed a significant persisting shunt in two out of 16 or 12%.
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D003097:Collateral Circulation; D003490:Cyanosis; D005500:Follow-Up Studies; D006327:Heart Block / Q000453:epidemiology; D006439:Hemodynamics; D006470:Hemorrhage / Q000401:mortality; D006801:Humans; D008875:Middle Aged; D010166:Palliative Care; D011183:Postoperative Complications / Q000453:epidemiology; D012131:Respiratory Insufficiency / Q000453:epidemiology; D013771:Tetralogy of Fallot / Q000401:mortality / Q000601:surgery*