Js. Hokanson et Jh. Moller, Significance of early transient complete heart block as a predictor of sudden death late after operative correction of tetralogy of Fallot, AM J CARD, 87(11), 2001, pp. 1271-1277
Citations number
22
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
We evaluated the long-term outcome and incidence of sudden death in the 288
patients discharged after corrective operation for tetralogy of Fallot at
the University of Minnesota between 1954 and 1974, The perioperative charac
teristics of these patients were evaluated with respect to their long-term
outcome. A health status survey was sent to each survivor and their functio
nal status was evaluated with respect to the perioperative variables. Curre
nt follow-up was available in 279 of 288 of the postoperative survivors (97
%); the mean duration of follow-up was 28 years. The 40-year survival rate
was 76% and 154 of 163 of survey responders (95%) were in New York Heart As
sociation class I or II. Twenty-six of the 288 died suddenly (9%). Those wi
th transient complete heart block that persisted beyond the third postopera
tive day had a lower long-term survival rate (p <0.001) and a higher incide
nce of late sudden death (p <0.001). Patients aged > 12 years at operation
had a lower long-term survival rate (p <0.001) and less favorable long-term
functional status. The use of a transannular patch was associated with inc
reased late morbidity but not mortality, Thus, the very long-term outcome a
fter operative correction of tetralogy of Fallot is excellent. Late sudden
death remains a concern for operative survivors, occurring in 9% of these p
atients. Late sudden death is strongly associated with transient complete h
eart block that persisted beyond the third postoperative day. (C) 2001 by E
xcerpta Medico, Inc.