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Ann Thorac Surg 1984;38:151-156
© 1984 The Society of Thoracic Surgeons


Articles

Long-term Prognosis (15 to 26 Years) after Repair of Tetralogy of Fallot: I. Survival and Symptomatic Status

Amnon Rosenthal, M.D.*, Douglas Behrendt, M.D., Herbert Sloan, M.D., Pauline Ferguson, Sandy M. Snedecor, M. Anthony Schork, Ph.D.

Division of Pediatric Cardiology and the Section of Thoracic Surgery, C. S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI

Accepted for publication February 10, 1984.

* Address reprint requests to Dr. Rosenthal, Division of Pediatric Cardiology, C. S. Mott Children's Hospital, F1123, Box 66, Ann Arbor, MI 48109

One hundred eighty-two patients with tetralogy of Fallot repaired before or during 1967 were studied by interview, physical examination, and noninvasive testing. Twenty were excluded from the final analysis because review of cineangiograms and operative reports disclosed that they had had double-chambered right ventricle rather than tetralogy of Fallot.

On follow-up ranging from 15 to 26 years (mean, 20.2 years), there were 86 patients in New York Heart Association Functional Class I, 53 in Class II, 5 in Class III, and none in Class IV. There were 9 late deaths. Functional classification was not ascertained in the remaining 9 patients. Cumulative survival at 25 years postoperatively was 94.4%. There was no significant relationship between survival and year of operation, age at operation, sex, or presence of a prior shunt. The 9 late deaths occurred between 6 and 23 years after operation and were due to late-onset complete heart block in 2 patients, congestive failure in 4, suicide in 1, accident in 1, and an unknown cause in 1. We conclude that long-term survival after repair of tetralogy of Fallot is excellent and not influenced by prior shunt.




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