Tetralogy of Fallot in teenagers and adults: Surgical experience and follow-up

Akshay Kumar Bisoi, John Santosh Kumar Murala, Balram Airan, Ujjwal Kumar Chowdhury, Shyam Sunder Kothari, Hemraj Pal, Chetan D. Patel, Sai Krishna Cheemalapati, Sandeep Chauhan, Venugopal Panangipalli

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9 Scopus citations

Abstract

Objective. The aim of this study was to review short- and long-term outcomes following total correction in patients with tetralogy of Fallot that presented during adulthood. Methods. It was a retrospective analysis of 284 patients (aged 14-50 years, mean 19.4 ± 2.5 years) with tetralogy of Fallot who underwent total correction at our institution between January 1991 and December 2001. Thirty patients were subjected to postoperative first-pass radionuclide angiocardiography scans. A Hindi version of the standard World Health Organization quality of life proforma was mailed to 120 patients operated on during the first half of the study period. Results. Altogether, 45 (15.8%) patients had palliative shunts, and 32 (11%) had preoperative coil embolization. The transatrial/transpulmonary artery approach was used in 62 (22%) patients, the transventricular approach in 86 (30%) patients, and a combined approach in 136 (48%) patients. A transannular pericardial patch was used in 200 (70%) patients. A total of 61 (21%) patients had nonfatal complications. There were 28 hospital deaths. Follow-up ranged from 1 month to 10 years (mean 4.6 ± 2.3 years). There were 7 (2.5%) late deaths and 6 (2.1%) reoperations. Altogether, 94% of patients were in New Yk Heart Association (NYHA) class I. Radionuclide angiocardiography showed normal right ventricular and left ventricular function in 18 (60%) and 22 (73%) patients, respectively. All of the 66 respondents perceived an improved quality of life. The actuarial survival and freedom from reoperation at 10 years were 82.88% ± 3.80% and 92.82% ± 3.40%, respectively. Conclusion. Total correction in this subset of patients offers the best option for long-term symptom-free survival.

Original languageEnglish (US)
Pages (from-to)105-112
Number of pages8
JournalGeneral Thoracic and Cardiovascular Surgery
Volume55
Issue number3
DOIs
Publication statusPublished - Mar 1 2007

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Keywords

  • Adult
  • Quality of life
  • Right ventricle
  • Survival
  • Tetralogy of Fallot

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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