Long-term results of the intracardiac repair of tetralogy of Fallot: a follow-up study conducted over more than 20 years on 100 consecutive operative survivors.

A long-term retrospective and follow-up study was conducted on patients with tetralogy of Fallot to evaluate survival rates and quality of life following surgery. Intracardiac repairs were performed on 132 patients at our institute between January, 1965, and July, 1971, among whom 100 consecutive operative survivors, being 54 males and 46 females, were followed for 20-25 years. Late deaths were confirmed in eight patients (8%) six of which (6%) were considered cardiac deaths. The 20- and 25-year survival rates were 93.7 +/- 2.5% and 90.9 +/- 3.6%, respectively. Reoperations were performed on six patients for residuae or sequelae without mortality or morbidity, and 90.4% +/- 3.1% of the patients were free from late death or reoperation at 20 years and 83.9 +/- 5.3% at 25 years. Thirty-one of the 46 female patients were married and 28 had children. Forty-three live births were confirmed without any association of a congenital heart anomaly. Employment status was satisfactory in most of the patients, and 81%-89% of the patients in this series were considered to have a good quality of life. Less than half the patients had late symptoms, and all were related to cardiac arrhythmias. Late ventricular arrhythmias remain the major concern of the future, and therefore, the establishment of effective pre- and intraoperative management to prevent postoperative arrhythmias is essential.