PMID- 18071607
OWN - NLM
STAT- MEDLINE
DCOM- 20080429
LR  - 20200825
IS  - 0304-4602 (Print)
IS  - 0304-4602 (Linking)
VI  - 36
IP  - 11
DP  - 2007 Nov
TI  - Late complications following tetralogy of Fallot repair: the need for long-term 
      follow-up.
PG  - 947-53
AB  - INTRODUCTION: We report a series of operated tetralogy of Fallot (TOF) patients 
      focusing on complications and outcomes. MATERIALS AND METHODS: Data from TOF 
      patients seen at our centre's adult congenital heart disease clinic was analysed. 
      RESULTS: There were 21 patients: the mean age was 32.2 +/- 12.4 years; the age at 
      first operation was 9.0 +/- 7.9 years; the mean postoperative follow-up duration 
      was 23.5 +/- 12.1 years; and the current New York Heart Association (NYHA) 
      status: I, 82%; II, 4%; III, 14%. Fourteen patients had complete operative notes. 
      All these patients underwent total TOF correction; 2 had staged aortopulmonary 
      shunt with total correction at a mean of 3.2 years later, pulmonary artery patch 
      augmentation in 8 patients and pulmonary valvotomy in 8 patients. Three patients 
      required pulmonary valve homograft replacement for severe pulmonary regurgitation 
      (PR) at 13, 28 and 36 years after the initial corrective operation. CURRENT 
      INVESTIGATIONS: RBBB on ECG (91%), QRS duration 137 +/- 29 ms. Echocardiography 
      showed dilated right ventricular end-diastolic (RVED) diameters (3.2 +/- 0.8 cm); 
      severe PR (67%), residual right ventricular outflow tract obstruction (RVOTO) 
      (42%) and VSD patch leakage (9%). Cardiac magnetic resonance (CMR) (8 patients) 
      showed dilated RVED volumes 252.6 +/- 93.8 mL, indexed RV volume 165.7 +/- 34.8 
      mL; RV systolic function was preserved in most patients with a RV ejection 
      fraction of 49.5 +/- 5.7%. One patient had atrial tachycardia and another had 
      frequent non-sustained ventricular tachycardia that required radiofrequency 
      ablation. CONCLUSION: Patients with TOF who had full corrective surgery during 
      childhood are now surviving into adulthood. Many challenges arising from 
      complications in the postoperative period remain. It is imperative that adult TOF 
      patients should have regular followup to monitor development and subsequent 
      management of these complications.
FAU - Ho, Kay Woon
AU  - Ho KW
AD  - Department of Cardiology, National Heart Centre, Singapore.
FAU - Tan, Ru San
AU  - Tan RS
FAU - Wong, Keng Yean
AU  - Wong KY
FAU - Tan, Teng Hong
AU  - Tan TH
FAU - Shankar, Sriram
AU  - Shankar S
FAU - Tan, Ju Le
AU  - Tan JL
LA  - eng
PT  - Journal Article
PL  - Singapore
TA  - Ann Acad Med Singap
JT  - Annals of the Academy of Medicine, Singapore
JID - 7503289
SB  - IM
MH  - Adult
MH  - Echocardiography
MH  - Female
MH  - Humans
MH  - Male
MH  - Outcome Assessment, Health Care/*methods
MH  - Postoperative Complications/*epidemiology/physiopathology
MH  - Singapore/epidemiology
MH  - Tetralogy of Fallot/*surgery
EDAT- 2007/12/12 09:00
MHDA- 2008/04/30 09:00
CRDT- 2007/12/12 09:00
PHST- 2007/12/12 09:00 [pubmed]
PHST- 2008/04/30 09:00 [medline]
PHST- 2007/12/12 09:00 [entrez]
PST - ppublish
SO  - Ann Acad Med Singap. 2007 Nov;36(11):947-53.