Early and late results after repair of tetralogy of Fallot

Publisher Website
Google Scholar
Abstract
Between January 1, 1975, and December 31, 1988, 233 patients wereoperated on for correction of tetralogy of Fallot (TOF). Mean follow-up was13.9 years (median 7.65 years) and was 99.6% complete. Actuarial survivalwas 84 +/- 3%. The risk of death decreased gradually to a constant rate of0.00034 deaths/month by the 6th postoperative month. There were 22 earlydeaths, due mostly to Low Output Syndrome. The principal incremental riskfactor was the postrepair ventricular pressure ratio (PRV/LV) (P less than0.0001). Other factors were: patent ductus arteriosus (PDA; P = 0.02),other associated anomalies (P = 0.005), higher preoperative hemoglobinlevels (P = 0.06) and use of transannular patches (P = 0.02). The operativerisk was significantly reduced by a recent operative date (P = 0.01) and byan older age at operation (P = 0.12). Among 8 late deaths, 2 were unrelatedto the cardiac condition, 2 occurred suddenly, 3 were due to congestiveheart failure and the last was due to reoperation for patch endocarditis.The risk of late death was significantly higher in patients operated on atan older age (P = 0.04). There were 10 open heart reoperations: 5 for patchdehiscence, 4 for residual pulmonary stenosis and 1 for residual atrialseptal defect. The reoperation-free actuarial survival was 82 +/- 3%. Withthe present operative standards, the parametric operative risk of anaverage patient with simple TOF (hemoglobin = 12 g, PRV/LV = 0.5) is 0.7%.Where the TOF is severely cyanotic (hemoglobin = 25 g) and the pulmonaryarteries are severely restricted, the average mortality is 30%.(ABSTRACTTRUNCATED AT 250 WORDS)

This publication has 0 references indexed in Scilit: