What are the reported outcomes for the surgical repair of tetralogy of Fallot (TOF) in adults?

Updated: Nov 13, 2018
  • Author: Shabir Bhimji, MD, PhD; Chief Editor: Yasmine S Ali, MD, FACC, FACP, MSCI  more...
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Answer

The few surgical series on adults patients report varying postsurgical results, with mortality ranging from 6% to 10%. After pulmonary valve replacement, some studies have shown a 5-year survival in excess of 90% and 86% at 10 years. However, although the short-term results after pulmonary valve replacement are good to excellent, the long-term outcomes are poor to fair. [34, 35, 36]  

In almost all case series, a number of patients have required redo procedures and/or pacemaker insertion, and some individuals have persistently elevated RVOT pressures. Others have even required re-replacement of their porcine valves.

Postoperative follow-up of adults with tetralogy of Fallot has shown that the pulmonary valve replacement also slows down or reverses the progression of some complications associated with pulmonary valve insufficiency, including RV dysfunction and tricuspid regurgitation. However, whether the surgery ameliorates the ventricular arrhythmias remains in debate. Some short-term studies reveal that there is a low incidence of arrhythmias in the postoperative period, but other long-term studies have not shown any difference. In general, arrhythmias continue to persist even after surgery in a number of patients tetralogy of Fallot who've undergone pulmonary valve replacement. [37]


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