[Clinical long-term results after corrective surgery of tetralogy of Fallot].
We studied 246 consecutive patients, mean age 11.9 +/- 6.7 years, with primary (n = 155) or secondary (n = 91) complete repair of tetralogy of Fallot (TOF) between 1961 and 1972. Prospective follow-up was complete and ranged from 18.1 to 29.3 (mean: 20.3 +/- 4.2) years. There were 46 operative and 21 late deaths. Cumulative survival was 0.76 +/- 0.03 after 1 year, 0.72 +/- 0.03 (10 years), 0.68 +/- 0.04 (20 years) and 0.63 +/- 0.05 (25 years). After 20 years of follow-up, which was a follow-up time available for all patients, cumulative complication rates were 0.17 +/- 0.03 for documented ventricular tachycardias/fibrillation, 0.16 +/- 0.03 for right-heart failure, 0.13 +/- 0.03 for left-heart failure and 0.11 +/- 0.03 for infective endocarditis. Eighteen of the 21 late deaths were from cardiac causes: sudden (n = 9), infective endocarditis (n = 4), left-heart failure (n = 3), and right-heart failure (n = 2). The hazard for ventricular arrhythmias was inconstant and increasing with time from the initial operation. After 20 years of follow-up, the cumulative incidence of sudden death, documented ventricular tachycardia/fibrillation was 0.81 +/- 0.07. Younger age at surgery resulted in a significantly better long-term prognosis (p = 0.03) with cumulative survival rates after 20 years being 0.90 +/- 0.06 (ages 1-9 years), 0.92 +/- 0.04 (10 to 14 years), 0.83 +/- 0.09 (15 to 19 years) and 0.69 +/- 0.11 for patients being operated beyond age 20. Twenty years following TOF repair 59.2% of the late survivors were in NYHA functional class I and 36.2% in NYHA II.
Horstkotte
D
D
Medizinische Klinik und Poliklinik, Heinrich-Heine-Universität Düsseldorf.
Paselk
C
C
Bircks
W
W
Loogen
F
F
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000401:mortality / Q000503:physiopathology / Q000601:surgery; D006333:Heart Failure / Q000401:mortality / Q000503:physiopathology / Q000601:surgery; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D011788:Quality of Life; D012086:Reoperation; D015996:Survival Rate; D013771:Tetralogy of Fallot / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*
Klinische Langzeitergebnisse nach Korrekturoperation einer Fallotschen Tetralogie.