title: Survey of reoperation indications in tetralogy of fallot in Japan.
abstract: BACKGROUND
  Although the survival rate for repaired Tetralogy of Fallot (TOF) is dramatically improving, anatomical and functional residua and sequelae followed by arrhythmias and sudden death are still challenging issues to be resolved. Reoperation can reduce the incidence of arrhythmias and sudden death, but there is no consensus on the indications of reoperation for patients with TOF, especially in Japan.
  
  
  RESULTS
  A cross-sectional questionnaire survey of reoperation indications in patients with TOF was performed through a Japanese multicenter study. The questionnaire, which focused on the number of repaired TOF patients aged >15 years old, reoperation indications and management, was sent to the institutions belonging to Japanese Society for Adult Congenital Heart Disease. In total, 41.5% (78/188) of the institutions replied. The total number of repaired TOF patients was 4,010, and sudden cardiac death was observed in 45.236/4,010 (5.9%) experienced reoperation. Pulmonary stenosis (32%) and pulmonary regurgitation (29%) were the most common reasons for reoperation. There were only 2 implantable cardioverter defibrillator or resynchronization therapy defibrillator implantations. The physiological/anatomical indications of reoperation differed among the hospitals.
  
  
  CONCLUSIONS
  Approximately 1.1% of patients suffered sudden death and 6% of repaired TOF patients had reoperation. The indications of reoperation, however, varied among the institutions. Therefore, detailed information for each case of sudden death or reoperation should be collected and analyzed in order to establish guidelines for reoperation.
authors.affiliation: Research Committee, Japanese Society for Adult Congenital Heart Disease, ST. Luke's International Hospital.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Mizuno
authors.forename: Koichiro
authors.initials: K
authors.lastname: Niwa
authors.forename: Kozo
authors.initials: K
authors.lastname: Matsuo
authors.forename: Masaaki
authors.initials: M
authors.lastname: Kawada
authors.forename: Aya
authors.initials: A
authors.lastname: Miyazaki
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Mori
authors.forename: Norifumi
authors.initials: N
authors.lastname: Nakanishi
authors.forename: Hideo
authors.initials: H
authors.lastname: Ohuchi
authors.forename: Mamie
authors.initials: M
authors.lastname: Watanabe
authors.forename: Atsushi
authors.initials: A
authors.lastname: Yao
authors.forename: Kei
authors.initials: K
authors.lastname: Inai
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D016757:Death, Sudden, Cardiac / Q000453:epidemiology; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D011795:Surveys and Questionnaires; D013771:Tetralogy of Fallot / Q000401:mortality* / Q000503:physiopathology / Q000601:surgery*