[The adult patient after surgical repair of tetralogy of Fallot: the never-ending story].

Tetralogy of Fallot is a common complex congenital heart disease, nowadays amenable to safe surgical repair with good early and long-term outcomes. Notwithstanding this, surgical repair is not a definite treatment, and the heart of patients with tetralogy of Fallot remains anatomically, physiologically and electrically abnormal. Indeed, long-term survival of patients with repaired tetralogy of Fallot differs from that of the general population. Major long-term complications include supraventricular and ventricular arrhythmias, with risk of sudden cardiac death, and chronic pulmonary regurgitation, which gradually leads to right ventricular dilation and dysfunction. Thus, the primary aims of clinical follow-up for adult patients with repaired tetralogy of Fallot should be to assess ventricular morphology and function, to stratify the arrhythmic risk and to define the optimal surgical or interventional timing.