Follow-up in the Surgical Treatment of Tetralogy of Fallot

Objective: The purpose of this study is to evaluate the early and intermediate results after total correction of Tetralogy of Fallot in 193 consecutive patients, with a mean age of 29 months, who underwent surgical correction in Transplant and Cardiovascular Disease Institute Târgu Mureș between 2005 and 2011.
Methods: The records of these patients were reviewed. Follow-up was obtained through clinical appointments and telephone questionnaires.
Results: One-hundred forty-four (74%) patients underwent single-stage complete repairs; 49 (25%) patients underwent initial palliative operations (systemic-pulmonary shunt), whereas 40 (20%) of them underwent secondary total corrections. Early and late mortality was 2% (n=4) and 2.5% (n=5), respectively. Mean follow-up was 35 months (range: 4 months to 71 months). Respiratory infection was a risk factor for early mortality (p=0.0032). For the reconstruction of the right ventricular outflow tract we used 21 valved conduits, 68 transannular patches and for the others patients right ventricular patches + pulmonary valvuloplasty/valvulotomy. On late postoperative echocardiography, 59 patients presented moderate pulmonary regurgitation, 21 a small residual ventricular septal defect, 4 severe residual dynamic stenosis of RVOT and 5 calcifications of the transannular patch, for whom we carried out 7 replacements of the pulmonary valve and 14 reconstructions of the right ventricular outflow tract.
Conclusions: Surgical repair of patients with simple or complex forms of tetralogy of Fallot can be achieved with low early mortality. Late mortality and the need for reoperation continue to influence the quality of life for these patients.

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