LONG-TERM RESULTS OF TOTAL REPAIR OF TETRALOGY OF FALLOT IN ADULTHOOD- 35 YEARS FOLLOW-UP IN 104 PATIENTS CORRECTED AT THE AGE OF 18 OR OLDER

Long-term survival after surgical repair of tetralogy of Fallot (TOF) is reported to be excellent if the patients are corrected in childhood . However, age at operation has been demonstrated as an important risk -factor. The aim of our study was to investigate whether adult patient s also benefit from surgery. From December 1958 to May 1977, 739 patie nts underwent a correction of their TOF with pulmonary stenosis at our institution. Foreigners (n=52) and those who moved to a foreign count ry (n=13) were excluded from further analysis. Sixteen patients were l ost during follow-up (98% complete). Of the remaining patient populati on (n=658; mean age: 12.2 +/- 8.6 years; range 2-67 years), 104 patien ts were 18 years or older at-the time of correction. Operative (n=25) and one-year (n=8) deaths were excluded for long-term calculations, re sulting in a study group of 71 patients. Actuarial 10,20,30, and 35-ye ar survival rates were 94%,93%,83%, and 72% respectively, and not diff erent from normal life expectancy. The most common cause of death was congestive heart failure (n=3), followed by myocardial infarction (n=2 ) and sudden death (n=2). Parameters influencing longterm survival cou ld not be detected. At follow-up (mean 27.7 years), more than 80% (n=4 8) of the 58 survivors reported themselves to be in NYHA functional cl ass I or II and 95% (n=55) were in a better condition than before the operation. Repair of tetralogy of Fallot in adulthood shows excellent results with normal life expectancy for the patients.