Long term outcome after surgical tetralogy of Fallot repair at young age: Longitudinal follow-up up to 50 years after surgery.
Robert M. Kauling, Sahra Ünlütürk, Judith A.A.E. Cuypers, Annemien E. van den Bosch, Alexander Hirsch, Chiara Pelosi, Daniel J. Bowen, Ad J.J.C. Bogers, Willem A. Helbing, Isabella Kardys, Jolien W. Roos‐Hesselink
Abstract
BACKGROUND: Little is known about the very long-term outcome in Tetralogy of Fallot (ToF) patients. OBJECTIVES: To prospectively evaluate clinical outcome and quality-of-life after surgical repair of ToF. METHODS: Single-centre, longitudinal cohort-study evaluating every decade 144 ToF patients who underwent surgical repair <15 years of age between 1968 and 1980. RESULTS: max was reduced in 53 % of patients but stable over time. Self-perceived quality-of-life was stable and comparable to the general Dutch population. Early post-operative arrhythmias, pre-operative low oxygen saturation of the left atrium, VT and declining exercise capacity over time were predictive for mortality, transannular patch for both arrhythmia and pulmonary valve replacement. Surgery post-1975 was protective for pulmonary valve replacement. CONCLUSION: Only 9 % of ToF patients is alive without a major event at 50 years after surgical repair. Reintervention and symptomatic arrhythmias are especially common, although symptomatic VT is rare. Exercise capacity and self-perceived quality-of-life remained stable.