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J Thorac Cardiovasc Surg 1995;110:883-891
© 1995 Mosby, Inc.


SURGERY FOR CONGENITAL HEART DISEASE

CARDIAC STATUS AND HEALTH-RELATED QUALITY OF LIFE IN THE LONG TERM AFTER SURGICAL REPAIR OF TETRALOGY OF FALLOT IN INFANCY AND CHILDHOOD

Folkert Meijboom, MDa, Andras Szatmari, MDa, Jaap W. Deckers, MD, PhDb, Elisabeth M. W. J. Utens, PhDc, Jos R. T. C. Roelandt, MD, PhDb, Egbert Bos, MD, PhDd, John Hess, MD, PhDa


Rotterdam, The Netherlands

Received for publication Sept. 1, 1994 Accepted for publication Jan. 20, 1995. Address for reprints: Folkert Meijboom, MD, Sohia Children's Hospital, Dr Molewaterplein 60, 3015 GJ Rotterdam, The Netherlands.

Abstract

The long-term results of surgical repair of tetralogy of Fallot were assessed by means of extensive cardiologic examination of 77 nonselected patients 14.7±2.9 years after surgical repair of tetralogy of Fallot in infancy and childhood. Because of the frequent use of a transannular patch (56%) for the relief of right ventricular outflow tract obstruction, the prevalence of elevated right ventricular systolic pressure was low (8%), but the prevalence of substantial right ventricular dilation with severe pulmonary regurgitation was high (58%). The exercise capacity of patients with a substantially dilated right ventricle proved to be significantly decreased (83%±19% of predicted) when compared with that of patients with a near normal sized right ventricle (96%±13%). Eight out of 10 patients who had needed treatment for symptomatic arrhythmia had supraventricular arrhythmia, which makes supraventricular arrhythmia—in numbers—a more important sequela in the long-term survivors than ventricular arrhythmia. Older age at the time of the operation and longer duration of follow-up were not associated with an increase in prevalence or clinical significance of sequelae. (J THORACCARDIOVASCSURG1995; 110:883-91)




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