CARDIAC STATUS AND HEALTH-RELATED QUALITY-OF-LIFE IN THE LONG-TERM AFTER SURGICAL REPAIR OF TETRALOGY OF FALLOT IN INFANCY AND CHILDHOOD

The long-term results of surgical repair of tetralogy of Fallot were a ssessed by means of extensive cardiologic examination of 77 nonselecte d patients 14.7 +/- 2.9 years after surgical repair of tetralogy of Fa llot in infancy and childhood. Because of the frequent use of a transa nnular patch (56%) for the relief of right ventricular outflow tract o bstruction, the prevalence of elevated right ventricular systolic pres sure,vas low (8%), but the prevalence of substantial right ventricular dilation with severe pulmonary regurgitation was high (58%). The exer cise capacity of patients with a substantially dilated right ventricle proved to be significantly decreased (83% +/- 19% of predicted) when compared with that of patients with a near normal sized right ventricl e (96% +/- 13%). Eight out of 10 patients who had needed treatment for symptomatic arrhythmia had supraventricular arrhythmia; which makes s upraventricular arrhythmia-in numbers-a more important sequela in the long-term survivors than ventricular arrhythmia. Older age at the time of the operation and longer duration of follow-up were not associated with an increase in prevalence or clinical significance of sequelae.