A correlative study of the functional class and hemodynamic status following intracardiac repair of tetralogy of Fallot.

An attempt was made to correlate the NYHA Functional class with the hemodynamic status of 196 patients at an average of 21.2 months following the intracardiac repair of tetralogy of Fallot. 171 patients were in Functional class I (87.2%), 9 in class III (4.5%), 5 in class II (2.5%) and 11 in class IV (5.6%). Right and left heart catheterisation and cardiac angiography revealed the hemodynamic status of these patients to be excellent in 92 (46.4%), good in 37 (18.8%), satisfactory in 6 (3.0%) and unsatisfactory in 61 (31.6%). Whereas all patients in Functional class II, III and IV had unsatisfactory hemodynamic findings, patients in Functional Class I were hemodynamically heterogeneous and included excellent (53.8%), good (21.6%), satisfactory (3.5%) and unsatisfactory (21%) groups. The surgical technique did not seem to determine the functional status. While early reoperation is advisable for patients with functional disability, caution is necessary in considering reoperation for patients in Functional class I who have hemodynamic findings which are classified as unsatisfactory.